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PALS Sequence Algorithm

15-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)

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