PALS Algorithm

Pediatric Advanced Life Support (PALS) provides the clinical framework for recognizing and managing life-threatening emergencies in infants and children. Unlike adult resuscitation, pediatric cardiac arrest is rarely a primary cardiac event; it most often results from progressive respiratory failure or circulatory shock. Early recognition and intervention before arrest occurs is the defining priority of PALS.

The 2025 AHA Guidelines reflect the most current evidence from the International Liaison Committee on Resuscitation (ILCOR) and introduce updated protocols across respiratory management, shock recognition, cardiac arrest, and post-resuscitation care.

What Is the PALS Algorithm?

PALS algorithms are structured, evidence-based clinical protocols used to assess and manage pediatric patients – infants and children up to puberty – experiencing respiratory distress, respiratory failure, shock, cardiac arrest, or life-threatening arrhythmias.

Where BLS focuses on the immediate response to arrest, PALS extends the clinical framework to include the recognition and treatment of conditions that lead to arrest. The goal is intervention early enough to prevent deterioration into cardiac arrest and, when arrest does occur, to deliver high-quality resuscitation with the best possible neurological outcome.

Explore Detailed PALS Algorithms

Pediatric Cardiac Arrest Algorithm

The Pediatric Cardiac Arrest Algorithm helps healthcare providers manage cardiac arrest in infants and children in a clear, step-by-step way. It focuses on quickly identifying the heart rhythm, delivering effective CPR, using defibrillation when needed for shockable rhythms, and giving the appropriate medications based on the situation.

Pediatric Bradycardia with a Pulse Algorithm

The Pediatric Bradycardia Algorithm provides a structured approach for managing children who have a slow heart rate with a pulse and show signs of poor perfusion or clinical instability. It is used when the heart rate drops below the normal range for the child’s age and begins to affect circulation.

Pediatric Tachyarrhythmia with a Pulse Algorithm

The Pediatric Tachycardia Algorithm helps healthcare providers assess and manage children who present with an abnormally fast heart rate while still maintaining a pulse. A key step is determining whether the rhythm is a normal sinus tachycardia or a more serious abnormal arrhythmia.

PALS Systematic Approach Algorithm

The PALS Systematic Approach Algorithm serves as the basic framework used to assess pediatric patients before applying any specific PALS interventions. It guides providers through a step-by-step evaluation starting with an initial impression, followed by a primary assessment using the ABCDE method, and then a more detailed secondary assessment.

Pediatric Septic Shock Algorithm

The Pediatric Septic Shock Algorithm supports clinicians in quickly identifying and managing septic shock in infants and children. It emphasizes early recognition, prompt fluid resuscitation, timely antibiotic administration, and appropriate selection of vasopressors.

Pediatric Post-Resuscitation Care Algorithm

The Pediatric Post-Resuscitation Care Algorithm focuses on stabilizing children after the return of spontaneous circulation (ROSC). It guides providers in supporting breathing and oxygen levels, maintaining stable blood pressure, managing blood glucose, regulating temperature, and closely monitoring neurological status.