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Writer's pictureThe Resuscitation Coach

PALS Cardiac Arrest (VF/ pVT)

In contrast to adult cardiac arrest, cardiac arrest in infants and children usually results from progressive respiratory failure or shock rather than a primary cardiac cause. This hypoxic/asphyxial arrest occurs most often in infants and young children, especially those with underlying disease. It is important to identify and treat respiratory distress, respiratory failure, and shock before progression to cardiopulmonary failure and cardiac arrest.


Early identification and treatment are crucial to saving the lives of seriously ill or injured children.


Sudden cardiac arrest from ventricular arrhythmia occurs in about 5% to 15% of all pediatric in-hospital and out-of-hospital cardiac arrests. Although a shockable rhythm like VF or pulseless ventricular tachycardia is the presenting rhythm in only about 14% of pediatric in-hospital arrests, it is present in up to 27% of such arrests at some point during the resuscitation.


The incidence of cardiac arrest from VF/pVT increases with age and should be suspected in any patient with a sudden collapse. Increasing evidence suggests that sudden unexpected death in young people is often associated with underlying cardiac conditions.


Despite the improved outcome of in-hospital CPR, most children with In-Hospital Cardiac Arrest (IHCA), and an even larger percentage of children with Out of Hospital Cardiac Arrest (OHCA), do not survive or survive with significant neurologic impairment.


Because the outcome from cardiac arrest is so poor, focus on preventing cardiac arrest is of utmost importance.


2020 Guidelines: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000903


Remember: BLS is the foundation of our PALS, if we don’t perform good BLS, the chances of us being successful in PALS diminishes significantly.


Push Hard and fast in the center of the chest at a rate of 100- 120 pushes per minute, Allow full chest recoil, don’t interrupt CPR, and push down to 1/3 of the Anterior/Posterior chest.


Keep in mind during single-rescuer CPR, the Compression to ventilation ratio is 30:2, and for 2 or more rescuers its 15:2


Disclaimer: This video is for educational purposes only, and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.


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