What Is Pediatric Advanced Life Support (PALS), and How Does It Save Lives?

Optimal working of the body requires harmonious coordination of different organs. However, adults and children can experience life-threatening disorders and injuries. Responding to them using life support techniques can help save a life.

Basic Life Support

BLS, or basic life support, is a course introduced by the American Heart Association (AHA) that teaches you to manage medical emergencies.

It involves the following steps:

  • Recognizing the signs of medical emergencies, including heart attack, stroke, foreign-body airway obstruction (FBAO), and sudden cardiac arrest
  • Carrying out cardiopulmonary resuscitation (CPR)
  • Performing defibrillation (using an automated external defibrillator)

BLS can be a matter of life or death for someone. Effective timely intervention can save the lives of individuals suffering from cardiac arrest or choking.

Immediate cardiopulmonary resuscitation can be life-saving for a patient in cardiac arrest.

Similar to BLS, pediatric advanced life support (PALS) is another lesser-known course that guides health professionals to save precious lives.

What Is Pediatric Advanced Life Support (PALS)?

Infants can suffer from fatal injuries and illnesses that require immediate life support. Thus, AHA developed the advanced pediatric life support (PALS) course to help save infant lives in medical emergencies through appropriate intervention in the given situation.

PALS builds upon the fundamentals of BLS. It refers to specialized training that prepares healthcare providers to treat life-threatening situations in infants and children. It includes BLS and ACLS training, but with special considerations for children and infants.

PALS certification is ideal for healthcare professionals who plan to serve critically ill or injured pediatric patients as it teaches them the best practices to care for them.

You can apply for a PALS certification training course online.

Some people need clarification on the efficacy of a web-based PALS course. A study suggests that web-based PALS is an acceptable way of learning and administering a PALS course.

PALS consists of different parts, including:

Assessment of the Condition

The first step in successful PALS is quick analysis and assessment of the situation. You need to identify the exact cause of the emergency (and the clinical events) and assess the available facilities. Differentiating between respiratory distress and respiratory failure is crucial.

You should also be able to recognize patients who need emergency medical intervention.

The assessment follows the ABCDE principle to identify and institute treatment for the life-threatening condition:

  • Airway (A)
  • Breathing (B)
  • Circulation (C)
  • Disability (D)
  • Exposure (E)

It is essential to evaluate and ensure a clear airway and maintain a breathing rate.

Assessing blood circulation involves focusing on skin color and sweating.

Assessing the neurological status and level of consciousness falls under the disability assessment.

Exposure involves focusing on signs of trauma and observing the body temperature (in case of hypovolemic shock).

Performing Resuscitation (CPR)

Cardiopulmonary resuscitation is the cornerstone of PALS. Performing appropriate resuscitation in cardiac arrest patients by keeping in mind the following points can help save a life:

  • Carrying out an adequate ratio of chest compressions and breaths
  • Being careful of the chest compression rate and depth
  • Allowing a complete chest recoil in between compressions
  • Minimizing interruptions
  • Avoiding excessive ventilation

According to the 2020 CPR guidelines for infants, use two fingers to perform 30 compressions on their chest. The compression depth should be about four centimeters of the chest depth. For a child hitting puberty, perform two-handed chest compressions with a depth of about two inches.

Open the airway by tilting the head back and give two breaths by creating a tight seal with your hands around your and the baby’s mouth. Allow their chest to rise. Giving CPR maintains the blood supply to the brain, lungs, and other vital organs of the body.n

Managing Foreign Body Airway Obstruction (FBAO) and Choking

Airway obstruction or foreign body airway obstruction occurs due to a small object blocking the upper airway, causing difficulty breathing for the child.

Managing the choking child involves encouraging the child to cough out the obstructing object. If the child begins to lose consciousness or turns pale/ blue, start blowing on the back.

Giving sharp back blows to infants using the heels of the hand by laying them down helps remove objects that are choking them.

For kids over one year, perform abdominal thrusts by standing behind the child. Encircle the torso while placing your arms under the child’s arms. Apply pressure on the lower rib cage and repeat four more times.

After abdominal thrusts, check the mouth for expelled objects. Continue back blows until the obstruction comes out.

Benefits of Pediatric Advanced Life Support: How It Saves Lives?

PALS certification provides comprehensive knowledge and necessary skills to health providers to deal with life-threatening emergencies in children.

Basic Resuscitation Knowledge

Research suggests that PALS is an effective program in improving and providing basic resuscitation knowledge to pediatric medical residents. Another study revealed that the course aids in increasing immediate short-term knowledge of pediatric resuscitation for professionals.

PALS training can significantly improve the efficiency of emergency medical service providers (EMS providers). It was concluded in a study that EMS personnel having PALS training have better procedural skills. Thus, PALS training should be a part of EMS training.

Better Survival of Patients

According to a study, the incidence of pediatric cardiac arrest was 8.04 per 100,000 person-years. Carrying out high-quality CPR improves the chances of survival of infants.

Improved Neurological Outcomes

Favorable neurological outcomes are difficult to attain due to difficulty in assessing the condition. Survivors receiving pediatric life support generally have better neurological outcomes.

Safety of the Urban Patients

According to a review, prehospital advanced life support providers must know about pediatric advanced life support data. Out of the 555 pediatric patients, a large majority were respiratory emergencies. Non-respiratory emergencies and trauma/accident cases were also present.

Appropriate training in high-risk procedures allows better management of pediatric emergencies, especially in urban populations.


Pediatric emergency assessment recognition and stabilization, or PEARS, is another life support course for healthcare professionals. The main aim is to identify shock, respiratory distress, and cardiac arrest symptoms. An overview of the BLS and shock recognition/ management is part of the course, but it is less elaborate than in the PALS.

In short, PALS is more about identifying and managing pediatric emergencies as a leader, whereas a PEARS training course does not teach you leadership roles.

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