PALS Sequence Algorithm
1. When evaluating the child’s level of consciousness, breathing and color, note:
- Level of consciousness – Is the child awake and alert, irritable and crying or unresponsive?
- Breathing – Is the child’s respiratory pattern normal for his age, diminished or absent, or extremely labored?
- Color – Is the child’s color normal for his ethnicity, cyanotic or pale, or mottled?
2. Is the child responsive and breathing normally?
No – Activate EMS and continue
Yes – Continue to Primary Assessment Sequence
3. Check the femoral of brachial pulse. Is it greater than 60 bpm?
No – Start high-quality CPR and continue for two minutes
Yes – Open airway and ventilate
4. If help is not available, access EMS and secure AED (leave child if necessary)
5. Provide high-quality CPR – for a single provider give 30 compressions and 2 breaths for two minutes before attempting other interventions (Two providers give 15 compressions and 2 breaths)
6. Check rhythm with AED and follow instructions (administer shock as needed)
