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PALS Provider Manual: Tips and Tricks to Remember PALS Algorithms

Pediatric advanced life support (PALS) training equips healthcare professionals to handle pediatric patients in emergency situations. A set of algorithms and protocols are in place to ensure that emergency victims receive the best possible care for a better chance of survival.

If you are preparing to earn your PALS certification for the first time, or you are brushing up on information to get recertified, a PALS provider manual may serve as a helpful resource. Here are a few tips and tricks for remembering algorithms and other important information.

Primary assessment: The ABCDE’s

When you have located an individual who may be in need of emergency care, you must give them a primary assessment. The steps of a primary assessment can be remembered with the mnemonic device, ABCDE. When assessing a child, some special considerations come into play.

Airway – Check to see if the victim’s airway is blocked.

Breathing – Check the individual’s breathing for rate, effort, tidal volume, airway patency, breath sounds and pulse oximetry in order to detect any worrisome patterns.

Circulation – Assess circulation by checking the patient’s heart rate, pulse, blood pressure, cardiovascular function and end-organ function.

Disability – Take a survey of the patient’s disability. This may be done through evaluation of the pupillary response, use of the AVPU Pediatric Response Scale or the Glasgow Coma Scale (GCS).

Exposure – Obtain adequate exposure. Everything the patient is wearing should be removed, allowing you to carefully survey the entire body, noting associated injuries or abnormalities. Young children, especially infants are prone to hypothermia, so care should be taken to preserve body temperature throughout the process.

Secondary assessment: SAMPLE

A more in-depth, secondary assessment is required following the ABCDE test. An easy way to remember the steps of the secondary assessment is the mnemonic device, SAMPLE.

Signs and symptoms – a symptom is something the patient or caregiver reports to you, while a sign is something you observe about the patient.

Allergies – ask the patient or the caregiver for a list of food and medication allergies.

Medications – ask the patient or the caregiver for a list of medications the patient is currently taking.

Past medical history – Gather information on the patient’s underlying medical conditions, surgeries, immunizations and general health history.

Last oral intake – Ask about the timing and content of the patient’s last oral intake, for the purpose of scheduling surgeries or other medical procedures.

Events leading to the injury or illness – This information can contribute to a possible diagnosis.

Assessing problems with intubation - DOPE

In cases of respiratory distress, patients must sometimes be intubated. In cases where deterioration in respiratory status occurs after an E.T. tube has been inserted, you can use the word DOPE as a mnemonic device to assess the possible causes.

Displacement – E.T. tubes in children can easily become displaced, and should be checked every time the patient is moved.

Obstruction – E.T. tubes in children can easily become occluded, because they are very small.

Pneumothorax – Check to see if breath sounds are diminished on one side, oxygen saturation is low, or tachycardia and tachypnea are present.

Equipment – Make sure that the equipment is functioning properly.

PALS provider manual and other resources at HealthEdSolutions.com


Health Ed Solutions is an online provider of healthcare certification courses for medical professionals and first responders. Offerings include online PALS certification courses and online PALS recertification courses, as well as advanced cardiac life support (ACLS), basic life support (BLS) and CPR/AED training. For more information on courses, as well as additional resources, similar to this PALS Provider Manual, visit HealthEdSolutions.com.