Note: Your progress in watching these videos WILL NOT be tracked. These training videos are the same videos you will experience when you take the full ProPALS Recertification program. You may begin the training for free at any time to start officially tracking your progress toward your certificate of completion.

  1. PALS Pharmacology Overview

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Show full transcript for PALS Pharmacology Overview video

In this section of your ProPALS course, we're going to cover the current PALS pharmacological treatment options. And in this lesson, we'll go over some important things to keep in mind as you progress through this section of your course.

It's important to remember that no medication will the work the way you want it to unless the patient's biological status is such that the patient's body, at the cellular level, is able to respond favorably to that medication.

What does that mean? When a person is in cardiac arrest, that person, at the cellular level, has only a short amount of time before clinical death progresses to biological or cellular death. (These two terms, cellular death and biological death are interchangeable, and we'll often use just one or the other, rather than both.)

 

As you can see in the video above, clinical death occurs around the six-minute mark, after the patient's breathing and heart rate have stopped. While biological death occurs around the 10-minute mark.

Pro Tip #1: As cellular hypoxia progresses to cellular death, the body's ability to react favorably to treatment becomes more difficult and more unlikely. Which is why it's important to provide high-quality and highly effective basic life support. This is the vital foundation for any successful PALS treatment, as effective basic life support buys you and the patient time by delaying the onset of biological death.

PALS Medications

The variety of medications that we'll cover in this section of the course are only one part of any successful resuscitation (and one part of the chain of survival) and will include:

  • Adenosine
  • Amiodarone
  • Atropine
  • Dopamine
  • Epinephrine
  • Lidocaine
  • Magnesium sulfate
  • Oxygen
  • Procainamide

The PALS Chain of Survival

Advanced life support is the next level in the chain of survival for pediatric patients. This chain of survival includes:

  • The administration of medications
  • ECG monitoring
  • Advanced airways
  • Other treatment options

Pro Tip #2: The goal of the PALS chain of survival is to keep the patient in a state of survivability, by delaying cellular death, until you can get the patient appropriate and definitive treatment that will reverse their life-threatening conditions.

Pediatric Drug Dosages

Compared with adult drug dosages, pediatric dosages vary greatly depending on that child's size. One helpful tool to determine a child's medication dosage for pediatric emergencies is known as a color-coded length-based tape, such as a Broselow tape.

The Broselow Tape, also called the Broselow pediatric emergency tape, will help you quickly determine a pediatric patient's weight so that you can better calculate their drug dosage.

How to Use a Broselow Tape

To use a Broselow tape, simply lay it next to the pediatric patient and measure from their head to their toes. The tape will then relate the child's height to his or her weight and provide you with information on:

  • The medication dosage that child needs
  • The size of resuscitation equipment that you should use
  • The level of AED shock that you'll need to deliver for defibrillating the patient

Pro Tip #3: The Broselow tape is designed for children up to approximately 12 years old, with a maximum weight of around 36 kilograms or 80 pounds.

Medication Breakdown

As we review the PALS medications in the upcoming lessons, we'll be breaking down the drugs into four distinct categories:

  1. The medication and its effect
  2. The medication's indications
  3. The medication's precautions and contraindications
  4. The appropriate dosages for each medication

A Word About Medication Therapy for Pediatric Cardiac Arrest

Your objectives as a PALS provider for administering medications to pediatric patients during cardiac arrest include:

  • Increase coronary and cerebral perfusion pressures and blood flow
  • Stimulate spontaneous or more forceful myocardial contractility
  • Accelerate the patient's heart rate
  • Correct and treat the possible cause for the patient's cardiac arrest
  • Suppress, or treat for, any arrhythmias

Medications that can be used while treating pediatric patients in cardiac arrest will be covered in detail in the upcoming lessons. But it's important to keep these objectives in mind as you progress through this section of your course.