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. Welcome to ProPALS: Introduction and Philosophy

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Welcome to the ProPALS course. This PALS (Pediatric Advanced Life Support) course was designed specifically for you, the busy healthcare professional.

ProPALS is available 24/7, whether you're watching a video for the first time, the third time, or coming back after several months for a quick refresher. We're here whenever you need us to be, regardless of your schedule.

We'll get into specific course objectives in the next lesson, but in this course, you can expect to gain all the guidelines and knowledge about current PALS regulations. Which will ultimately lead to meeting and exceeding the most important course objective:

Providing you with enough real-world knowledge so that when you're a team leader during a pediatric emergency, you can feel as confident as possible to contribute to a positive outcome in that patient's life.

Becoming that kind of confident takes action to achieve – as in, gaining a deeper knowledge than you already possess. Along with honing and refining the necessary skills that many of you already have.

It takes commitment and dedication, and it may require that you watch the videos more than once. It may mean practicing case scenarios several times until they become automatic.

However, what you'll get from that confidence isn't nearly as important as what you can do with that confidence – making a difference when it matters most and possibly saving a child's life.

Warning: Some things in this course may be familiar to you already, and if they are, that's not always a good thing. We tend to passively listen, read, and learn when things sound familiar. And when this happens, you're much more likely to miss a point or two that one day you may need. Fight this human tendency and you'll get much more from this course.

A Word About Important PALS Metrics

Some of this will be a preview of things to come. But it's important to set the table before sitting down for a meal. We're not animals, after all.

How we define infant: An infant is a boy or girl who is less than one year old, but excluding newborns, also known as neonates.

How we define child: A child is a boy or girl who is one year old up until signs of puberty, after which, we tend to put them into the adult category. For boys, first signs of puberty usually include the presence of chest hair and/or underarm hair. For girls, first signs of puberty include the first signs of breast development.

In this course, when we refer to infants and children, this is how we define those terms.

However, as you can see, there are a lot of years between infant and the first signs of puberty, and there may be times when being more precise will benefit you. Like understanding normal respiratory rates, heart rates, and blood pressure rates by age.

When you know what's normal, encountering rates that are NOT normal are often the first signs that something is wrong. The following rates are according to the AHA (American Heart Association).

Respiratory Rates by Age

Infant 30 – 53
Toddler 22 – 37
Preschooler 20 – 28
School-age child 18 – 25
Adolescent 12 – 20

Bradypnea – a slower than normal respiratory rate
Tachypnea – a faster than normal respiratory rate
Apnea – the absence of respiration, defined as longer than 15 seconds

Three Types of Apnea

1. Central apnea – when there is no respiration because of an abnormality or suppression of the brain or spinal cord.
2. Obstructive apnea – when airflow is completely or partially blocked.
3. Mixed apnea – when there are periods of both central apnea and obstructive apnea.

Heart Rates by Age

  Awake Sleeping
Neonate 100 – 205 90 – 160
Infant 100 – 180 90 – 160
Toddler 98 – 140 80 – 120
Preschooler 80 – 120 65 – 100
School-age child 75 – 118 58 – 90
Adolescent 60 – 100 50 – 90

Bradycardia – a slower than normal heart rate
Tachycardia – a faster than normal heart rate
Cardiac arrest – the absence of a heart rate

Blood Pressure Rates by Age

  Systolic Diastolic Mean
Neonate 67 – 84 35 – 53 45 – 60
Infant 72 – 104 37 – 56 50 – 62
Toddler 86 – 106 42 – 63 49 – 62
Preschooler 89 – 112 46 – 72 58 – 69
School-age child 97 – 115 57 – 76 66 – 72
Preadolescent 102 – 120 61 – 80 71 – 79
Adolescent 110 – 131 64 – 83 73 – 84

Systolic pressure (top number) – the amount of pressure in the arteries while the heart is contracting
Diastolic pressure (bottom number) – the amount of pressure in the arteries when the heart is between beats