AHA Pediatric Life Support (PALS) – Full Course
Full Course Time: Approximately 15 hours 20 minutes –$497.00 / per student
The AHA’s ACLS course builds on the foundation of lifesaving BLS skills, emphasizing the importance of continuous, high-quality CPR. Reflects science and education from the American Heart Association Guidelines Update for CPR and Emergency Cardiovascular Care (ECC).
- Basic life support skills, including effective chest compressions, use of a bag-mask device, and use of an AED
- Recognition and early management of respiratory and cardiac arrest
- Recognition and early management of peri-arrest conditions such as symptomatic bradycardia
- Airway management
- Related pharmacology
- Management of ACS and stroke
- Effective communication as a member and leader of a resuscitation team
The goal of this program is to provide students a valuable and enjoyable hands-on training experience.
The fundamental objective is to use a simple, practical approach to help students develop necessary knowledge, skills, and confidence to provide and direct lifesaving interventions as a lead emergency medical responder.
Lesson 1: PALS Course Overview
- Identify the risk factors for coronary artery disease.
- Define “cardiac arrest” and “sudden cardiac death.”
- Identify and describe the links in the Chain of Survival.
- Name four heart rhythms associated with cardiac arrest.
- Differentiate “shockable” cardiac arrest rhythms from “nonshockable” cardiac arrest rhythms.
- Identify the components of advanced cardiac life support.
- Describe the phases of cardiopulmonary resuscitation.
- List the purpose of components of the primary and secondary surveys.
- Explain advanced directives and do not resuscitate (DNR) orders.
Lesson 2: Overview of PALS Science
- Name the major structures of the respiratory system.
- Describe the oxygen liter flow per minute and estimated oxygen percentage delivered for each of the following devices:
- Nasal cannnula
- Simple face mask
- Partial nonrebreather mask
- Nonrebreather mask
- Venturi Mask
- Describe the steps in performing the head-tilt / chin-lift and jaw thrust without head-tilt maneuvers for opening the airway.
- Relate mechanism of injury to opening the airway.
- Describe correct suctioning technique and complications associated with the procedure.
- Describe how to correctly size and insert and oral airway and a nasal airway.
- Describe the indications for positive-pressure ventilation.
- Describe the oxygen liter flow per minute and estimated inspired oxygen concentration delivered for a pocket mask and bag-mask device.
- Describe how to ventilate a patient with a bag-mask using one and two rescuers.
- Describe the signs of adequate and inadequate bag-mask ventilation.
- Describe the advantages and disadvantages associated with the use of an automatic transport ventilator (ATV) and a flow-restricted, oxygen-powered ventilation device.
- Describe the indications, advantages, and technique for advanced airways including Combitube, laryngeal mask airway (LMA), and endotracheal (ET) tube.
Lesson 3: BLS Practice and Competency Testing
- Name the primary branches of the right and left coronary arteries.
- Describe the two types of myocardial cells and the function of each.
- Describe the significance of each waveform in the cardiac cycle.
- Describe the normal duration of the PR interval and QRS complex.
- Describe at least two methods of determining heart rate.
- Name the primary and escape pacemakers of the heart and the normal rates of each.
- Define the absolute and relative refractory periods and their location in the cardiac cycle.
- Describe the electrocardiogram (ECG) characteristics of narrow-QRS tachycardias.
- Describe the ECG characteristics and wide-QRS tachycardias.
- Describe the differentiation of right and left bundle branch block (BBB) using lead V1 or modified chest lead (MCL1)
- Describe the ECG characteristics of irregular tachycardias.
- Describe the ECG characteristics of sinus bradycardia, junctional escape rhythm, and ventricular escape rhythm.
- Describe the ECG characteristics of first-, second-, and third-degree atrioventricular (AV) blocks.
- Name and describe four dysrhythmias that may be observed during cardiac arrest.
- Describe the appearance of the waveform on the ECG produced as a result of atrial pacing and ventricular pacing.
Lesson 4: Management of Respiratory Emergencies
- Explain defibrillation and name three indications for this procedure.
- Describe four factors affecting transthoracic resistance.
- Describe proper placement of hand-held defibrillator paddles or self-adhesive monitoring / defibrillation pads.
- Discuss monophasic and biphasic defibririllation.
- Describe the procedure for defibrillation.
- Explain synchronized cardio-version and name three indications for this procedure.
- Describe the differences in the delivery of energy relative to the cardiac cycle with synchronized cardio-version and defibrillation.
- Describe the procedure for synchronized cardio-version.
- For each of the following rhythms, identify the energy levels currently recommended and indicate if the shock delivered should be a synchronized or unsynchronized counter shock:
- Pulseless ventricular tachycardia (VT) / ventricular fibrillation (VF).
- Monomorphic VT
- Polymorphic VT
- Narrow-QRS tachycardia
- Atrial fibrillation with a rapid ventricular response
- Atrial flutter with a rapid ventricular response.
- Differentiate between a fully automated external defibrillator (AED) and a semi-automated external defibrillator.
- List the steps in the operation of an automated external defibrillator.
- Explain the precautions that should be taken when defibrillating a patient with a permanent pacemaker or an implantable cardioverter-defibrillator.
- Discuss indications for transcutaneous pacing.
- List possible complications of transcutaneous pacing.
Lesson 5: Rhythm Disturbances / Electrical Therapy
- Describe the indications for intravenous (IV) therapy.
- Describe the sites of first choice for cannulation if no IV is in place at the time of cardiac arrest.
- Describe the advantages of peripheral venipuncture over central venous access.
- Describe the indications for central venous access.
- List four local complications common to all IV techniques.
- List four systemic complications common to all IV techniques.
- Describe the use of the intraosseous (IO) and endotracheal routes as alternate routes of medication delivery in cardiac arrest.
- Describe the location and effects of stimulation of alpha, beta, and dopaminergic receptors.
- Define the following terms: afterload, agonist, antagonist, chronotrope, dromotrope, inotrope, parasympatholytic, preload, and sympathomimetic.
- Identify the mechanism of action, indications, dosage, and precautions for each of the following medications:
Lesson 6: Vascular Access
- Define acute coronary syndromes (ACS).
- Describe the pathophysiology of coronary artery disease and the process of atherosclerosis.
- Differentiate the characteristics of stable (classic) angina, unstable angina, and acute myocardial infarction (MI).
- Explain atypical presentation and its significance in ACS.
- Identify the electrocardiogram (ECG) changes associated with myocardial ischemia, injury, and infarction.
- Explain the ECG criteria for significant ST-segment changes.
- Describe the initial assessment and immediate general treatment of acute coronary syndromes.
- Describe the inital management of a patient experiencing ST-elevation MI (STEMI), non-ST elevation MI (NSTEMI), and unstable angina.
- Explain the importance of the 12-lead ECG in ACS.
- Identify the ECG leads that view the anterior wall, inferior wall, lateral wall, and septum.
- Explain the clinical and ECG features of right ventricular infarction (RVI).
- Identify the most common complications of an acute MI.
Lesson 7: Resuscitation Team Concept
- Describe the two major types of stroke.
- Describe the sequence of events that occurs during a stroke.
- Discuss why stroke must be treated within the early hours of symptom onset.
- Identify the signs and symptoms of stroke.
- Understand the significance of a transient ischemic attack (TIA).
- Describe the initial emergency care for each of the following situations:
- Near-fatal asthma
- Traumatic cardiac arrest
- Cardiac arrest and pregnancy
- Electric shock and lightning strike
Lesson 8: Overview of Pediatric Assessment
- Describe the role of each member of the resuscitation team.
- Discuss the “phase response” of code organization.
- Describe the critical actions necessary in caring for the adult patient in cardiac arrest.
- Identify the immediate goals of post-resuscitation care.
- Given a patient situation, describe the initial emergency care (including mechanical, pharmacological, and electrical therapy where applicable) for each of the following situations.
- Cardiac arrest rhythms – Pulseless ventricular tachycardia (VT) / ventricular fibrillation (VF), asystole, pulseless electrical activity (PEA).
- Too slow rhythms – Symptomatic bradycardia
- Too fast rhythms – Narrow-QRS tachycardia, wide-QRS tachycardia, irregular tachycardia
- Acute coronary syndromes – ST-elevation myocardial infarction (STEMI), unstable angina / non-ST-elevation myocardial infarction (NSTEMI), nondiagnostic / normal electrocardiogram (ECG)