The PALS (Pediatric Advanced Life Support) Tachycardia Poor Perfusion Algorithm furnishes a framework employed in pediatric emergency medicine to handle instances of tachycardia accompanied by signs of poor perfusion, such as modified mental status or chilly, moist skin. It supplies detailed directives for evaluating and managing unstable tachycardia in children to enhance perfusion and stabilize their condition.

This algorithm is applied in hospital emergency departments, pediatric intensive care units, and other healthcare settings where pediatric cardiac emergencies arise.

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Details of Flowchart

  1. Potential Underlying Factors: Upon detecting inadequate perfusion, examine for potential underlying issues such as sepsis or hepatomegaly.
  2. ABC: If the child’s condition does not improve, attempt to clear the airway, administer rescue breaths, and perform chest compressions.
  3. QRS Evaluation: Assess whether the QRS complex is narrow (≤0.09 sec) or wide (>0.09 sec).
  4. Wide QRS Assessment: If the QRS complex is wide, evaluate the child’s vital signs for stability or instability.
  5. Compromised Child: In the event of a compromised child, prompt cardiologist intervention is essential.
  6. Uncompromised Child: If the child is not compromised, commence cardioversion.
  7. Narrow QRS: In cases of narrow QRS tachycardia, initiate PALS and employ the appropriate perfusion algorithm

Key Highlights

  1. Heart Range

    Age Group Normal Heart Rate (bpm)
    Newborns (0 to 1 month) 70 to 190 beats per minute (bpm)
    Infants (1 to 12 months) 80 to 160 bpm
    Toddlers (1 to 3 years) 80 to 130 bpm
    Preschoolers (3 to 5 years) 80 to 120 bpm
    School-age children (6 to 12 years) 70 to 110 bpm
    Adolescents (13 to 18 years) 60 to 100 bpm
    *The above are general guidelines, and individual variations may occur. You must consult a healthcare provider for specific concerns about your child’s heart rate.
  2. Cardioversion Rules

    QRS narrow and regular 50-100 Joules
    QRS narrow and irregular 120-200 Joules
    QRS wide and regular 100 Joules
    QRS wide and irregular Turn off the synchronized mode and defibrillate immediately


Download PALS Tachycardia Initial Management Algorithm PDF

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