Pediatric Advanced Life Support

PALS Course at Hamilton First Aid

Pediatric Advanced Life Support or PALS is an advanced program for health care providers, teaching them how to manage cardiac emergencies in children. The program further divides its curriculum into the management of infants, toddlers and younger children, and older school-age children. Major differences in management can be found in performing chest compressions and the administration of certain medication. Pharmacology is a very important topic, since adult dosages can be very dangerous and even fatal to children (especially infants).

Our PALS course runs for two full days, with class hours totaling up to 14 hours. Refresher courses for PALS are also available (with shorter class hours), targeting students who have previously taken the full, 14-hour PALS training program at Hamilton First Aid.

Cardiac Emergencies in Children

Managing emergencies in children is vastly different from managing an adult – especially for cardiac emergencies such as cardiac arrest. Heart attacks in children happen very different compared to an heart attacks in adults. In adults, a heart attack is usually caused by Coronary Artery Disease, a disease characterized by blockages (from plaque) in the arteries that supply the heart with oxygenated blood. Because tissues need oxygen in order to function, a lack of it causes tissue damage and death — in the heart, it can cause cardiac tissue necrosis also known as a myocardial infarction or a heart attack.

However, heart attacks happen very differently in children. The pathophysiology is a different because preexisting cardiac conditions such as Coronary Artery Disease are very rarely found in children, and almost non-existent in infants and toddlers because it is primarily caused by lifestyle choices. Congenital malformations in the heart are common causes of cardiac dysfunction in children, but heart attacks are usually attributed to respiratory failure.

In Acute Respiratory Failure (ARF), the lung stop working completely – meaning oxygen cannot be delivered into the lungs and into the blood. This means that while the heart is pumping blood normally, the oxygen content of the blood is severely depleted. This condition is called asphyxia. As previously explained, the lack of oxygen delivered to the heart causes tissue to die – an irreversible process that causes the heart to stop — also known as cardiac arrest.

Giving Chest Compressions to Children

  • For infants, use minimal force and only with two fingers. Use both thumbs with your hands around the infant’s chest and push down on the sternum (the space in the middle of the nipples), compressing it by one inch to 1.5 inches. You can also use the pointer and middle fingers of one hand.
  • For toddlers, use one hand, again with minimal force. Place the heel of your against the sternum and compress the chest by 1.5 inches.
  • One cycle is composed of 30 c0mpressions followed by 2 rescue breaths (ventilations).

PALS Training Credentials

There are two requirements students need to complete before we award them with a PALS credential – (1) complete attendance and (2) a passing grade on the certification exams (written and practical). Credentials are valid for three years and after that they expire.

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