Pediatric Resuscitation
Pediatric Advanced Life Support (PALS) — current guidelines, key 2025 changes, and maintained primary resources.
Pediatric Resuscitation
The 2025 American Heart Association and American Academy of Pediatrics Pediatric Advanced Life Support guideline is the current standard for resuscitation of infants and children up to 18 years of age, excluding newborns.
2025 AHA/AAP PALS Guidelines (Part 8)2025 AHA/AAP PALS Guideline · 2025 · Circulation2025 AHA/AAP pediatric advanced life support guideline covering prearrest, intra-arrest, and post-cardiac arrest care for infants and children up to 18 years (excluding newborns).View source ↗ — Circulation 2025;152(16_suppl_2):S479–S537. PMID 411228852025 AHA/AAP PALS Guideline · 2025 · Circulation2025 AHA/AAP pediatric advanced life support guideline covering prearrest, intra-arrest, and post-cardiac arrest care for infants and children up to 18 years (excluding newborns).View source ↗.
Key 2025 changes
These changes are drawn from the AHA 2025 Guidelines Executive Summary PMID 411228852025 AHA/AAP PALS Guideline · 2025 · Circulation2025 AHA/AAP pediatric advanced life support guideline covering prearrest, intra-arrest, and post-cardiac arrest care for infants and children up to 18 years (excluding newborns).View source ↗. Verify each recommendation against the full guideline before applying it at the bedside.
- Earlier epinephrine for nonshockable rhythms: administer the initial dose as early as possible.
- Epinephrine timing for shockable rhythms: may be given after 2 attempts at defibrillation, or sooner if rapid defibrillation is not possible.
- Diastolic blood pressure to guide CPR quality: when invasive arterial monitoring is in place, target diastolic BP ≥25 mm Hg in infants and ≥30 mm Hg in children ≥1 year of age.
- Post–cardiac arrest blood pressure targets: maintain systolic and mean arterial pressure at ≥10th percentile for age with continuous arterial monitoring.
- Neuroprognostication: avoid using a single data element (pupillary reflex, biomarker, EEG, or MRI alone) at any single time point to predict outcome. Multiple data points are required.
- Ventilation: 1 breath every 2–3 seconds with an advanced airway in place; cuffed ETT is preferred; cricoid pressure is no longer routine.
Maintained primary resources
- AHA PALS Course Options — official AHA/AAP co-branded PALS provider course, reference cards, and algorithms.
- 2025 AHA CPR & ECC Guidelines — Executive Summary — top-ten take-home messages and key changes from 2020.
- AHA 2025 CPR Highlights (PDF, 24pp) — visual summary of 2025 ECC Guidelines, includes updated ACLS and PALS algorithms.
- 2025 AHA Guidelines for CPR and ECC — full text — Circulation Oct 2025; 760 new recommendations across all resuscitation topics.
Drug dosing
Weight-based emergency drug dosing for PALS resuscitation, RSI, and dextrose is maintained on a separate page:
Doses on that page were sourced from AHA 2020 PALS and WikEM. They have not yet been verified against the 2025 guideline. Use with caution and confirm against the current 2025 AHA/AAP PALS guideline2025 AHA/AAP PALS Guideline · 2025 · Circulation2025 AHA/AAP pediatric advanced life support guideline covering prearrest, intra-arrest, and post-cardiac arrest care for infants and children up to 18 years (excluding newborns).View source ↗ before clinical application.
Related pages
- Neonatal Resuscitation — NRP algorithm and code medications for newborns. PALS guidance does not apply to newborns.
- Critical Care index — ACLS algorithms, sepsis bundles, ARDS, and mechanical ventilation.
- Hypoglycemia in Pediatrics — dextrose dosing and the Rule of 50s.