2010 Guidelines PALS Review Home

For decades, the American Heart Association, with the cooperation of the American Academy of Pediatrics has updated their Pediatric Advanced Life Support Provider Manual. The most recent recommendations found in the 2010 Guidelines for CPR & ECC are now incorporated in the most recent edition. (October 2011) The following outline some of the most important changes seen in these new recommendations.

New 2010 guidelines

  • Too much time is spent on pulse checks. No longer than 10 seconds should be taken, and if the child is unresponsive and not breathing, begin CPR.
  • There is new support for the use of cuffed endotracheal tubes in infants and young children.
  • Cricoid pressure during intubation is questioned, and it is recommended that the practice be either discontinued or modified.
  • Use of end-tidal CO2 monitoring is encouraged for monitoring ET tube placement and potentially for evaluating chest compressions.
  • Reaffirmation of the use of biphasic defibrillators in pediatrics.
  • Prevention of over-ventilation and hyperoxemia is encouraged.
  • Broader categories of cardiac pathology are discussed.
  • Call for unrestricted, complete autopsy in children with sudden cardiac arrest.
  • CPR for newborns is still recommended using a 3:1 ratio, unless the arrest is known to be of cardiac origin, then a ratio of 15:2 should be considered.
  • Because of the newly published PALS Provider Manual, all individuals participating in PALS recertification should review this updated document. The AMRI website for PALS, includes case studies and review questions based on the 2010 Guidelines. For practitioners who have maintained their knowledge of pediatric resuscitation, a brief review of the site material should be adequate to successfully pass the certification examination.

    If certain content is unclear, the new PALS Provider Manual should be used as a reference. All new PALS course participants should carefully read the manual, paying special attention to the patient-care algorithms. Finally, each participant must practice the skills required of their individual role as a PALS team member. These skills must be documented as part of the PALS Provider Course certification. (Refer to Skill Verification Sheet forwarded with your registration material) A pediatric BLS course qualifies for basic airway management and emergency ventilation. The AED module is accepted as proof of electrical therapy experience for the basic provider. Clinical personnel should certify on the equipment that they use for providing actual patient care.

    Continue to Case Study #1