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Pediatric Advanced Life Support (PALS) Cardiac Arrest (Asystole & PEA)

Updated: Dec 3, 2021

In this video we discuss the Pediatric Advanced Life Support (PALS) Cardiac Arrest Algorithm focussing on the non-shockable rhythms, Asystole and PEA.

In contrast to adult cardiac arrest, cardiac arrest in infants and children usually results from progressive respiratory failure or shock rather than a primary cardiac cause. This hypoxic/asphyxial arrest occurs most often in infants and young children, especially those with underlying disease. It is important to identify and treat respiratory distress, respiratory failure, and shock before progression to cardiopulmonary failure and cardiac arrest. Early identification and treatment are crucial to saving the lives of seriously ill or injured children.

Despite the improved outcome of in-hospital CPR, only 43% survive hospital discharge and only about 8% survive OHCA. Because the outcome from cardiac arrest is so poor, focusing on preventing cardiac arrest is of utmost importance.

We do know from data from Get with the Guidelines that the survival rate if the initial rhythm is VF or pVT is higher than if the initial rhythm is Asystole or PEA.

2020 Guidelines:

Remember: BLS is the foundation of our PALS, if we don’t perform good BLS, the chances of us being successful in PALS diminishes significantly.

Push Hard and fast in the center of the chest at a rate of 100- 120 pushes per minute, Allow full chest recoil, don’t interrupt CPR, and push down to 1/3 of the Anterior/Posterior chest.

Keep in mind during single-rescuer CPR, the Compression to ventilation ratio is 30:2, and for 2 or more rescuers its 15:2

Disclaimer: This video is for educational purposes only, and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.



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