Real-Life Scenarios: How PALS Training Makes a Difference?

Pediatric advanced life support (PALS) builds the critical skills to save young lives. But no two emergencies look alike in the real world. That is why PALS training utilizes case scenarios from inside the emergency bay and out in the field. When a child suffers from a seizure, cardiac arrest, or choking, quick recognition and intervention using pediatric life support protocols can mean the difference between life and tragedy. In this blog, we discuss how an online PALS certification for healthcare Professionals can help you make a difference in emergencies. 

What is PALS certification?

PALS certification refers to certification in Pediatric Advanced Life Support geared toward healthcare providers who care for pediatric patients in emergency or critical care settings. 

When you undergo PALS certification, you gain knowledge like recognition and management of critically ill or injured children and assessment of airway, breathing, circulation, disability, and exposure (the pediatric ABCDEs). You will also build key skills like pediatric basic and advanced airway management, bag-valve-mask ventilation, vascular access, use of medications, defibrillation and cardioversion

You learn the management of specific issues such as respiratory distress/failure, arrhythmias, shock, trauma, seizures, and cardiopulmonary arrest. The course also includes effective Emergency Medical Services (EMS) and interdisciplinary team communication and coordination.

Who is PALS certification for?

Anyone who deals with children on a regular basis can undergo PALS certification. In the healthcare sector, physicians, nurses, paramedics, and EMTs that care for children in emergency departments, intensive care units, anesthesia, or transport services may have to complete PALS certification. They must also update or renew the certification every two years. 

What is the certification process of PALS like?

The PALS certification process is very straightforward and easy to understand. You can opt for an online course or can go for the physical course. To pass the exam and earn the certification, you must demonstrate competency in all core skills through scenario-based assessments. 

Here is how you will earn your PALS certification- 

  1. Complete an accredited PALS course including online self-directed content.
  2. Go through a one or two-day in-person skills/simulation session.
  3. Pass a written exam.

How does PALS make a difference in real-life scenarios?

PALS training is all about the application of the knowledge and training received in a real-life emergency scenario. There are numerous real-life scenarios where a thorough PALS training comes in handy. Let’s take a look at some of those scenarios and see how PALS training can help deal with them. 

Scenario 1

How PALS training help respond to a newborn medical emergency?

It’s 3 AM when a neonate born at 35 weeks gestation suddenly develops difficulty breathing and his oxygen saturations drop into the 70s shortly after birth. The nurses tap their PALS training to swiftly assess and intervene.

Recognizing signs of respiratory distress like grunting, nasal flaring, and retractions, the nurse ensures the airway is open, positions the baby on his side, and provides tactile stimulation. She requests extra staff. When saturations don’t improve and bradycardia develops, the nurse initiates newborn CPR with proper positioning and gentle compressions coordinated with ventilations using a neonatal BVM appropriate for the infant’s size.

Applying PALS knowledge of respiratory and circulatory physiology unique to newborns, the team obtains IV access to provide a fluid bolus and epinephrine per established medication protocols. After 30 seconds of ventilations, they recognize asystole on the monitor as the likely cause and deliver shocks from a manual defibrillator using a pediatric attenuator and pads. Chest compressions resume as a breathing tube is successfully inserted by an arriving NICU nurse using specialized equipment.

Over 10 tense minutes, the PALS-trained staff adeptly perform CPR with rotations, push medications based on the baby’s weight, adjust oxygen delivery, and apply ECG pads and defibrillation until a heart rhythm returns and vital signs stabilize. The neonate is safely transferred to the NICU for post-resuscitation care. 

Scenario 2

How does PALS training help respond to a pediatric emergency involving a toddler-?

The morning starts innocuously enough with active 18-month-old Simon, until his babysitter notices him suddenly becomes quiet and lethargic after snacking on apple slices. When his breathing turns rapid and labored, she calls 911. The EMTs arriving on the scene recognize the signs of a severe allergic reaction and anaphylactic shock.

Applying their PALS assessment skills, they find Simon has a faint heartbeat, low blood pressure, and oxygen levels below 90%. As his level of consciousness rapidly worsens, they immediately deliver oxygen via a face mask to support his breathing while giving intramuscular epinephrine to counteract the reaction.

With fluids and close monitoring during transport, his blood pressure stabilizes, but Simon remains minimally responsive. On arrival, the pediatric ER team employs PALS protocols to systematically address airway, breathing, circulation, and neurological status. They establish IV access and administer corticosteroids, more epinephrine, and IV fluids tailored to his weight.

However, his oxygenation remains compromised. Recalling PALS training, the team rapidly sequences through difficult airway algorithms to establish a definitive airway. On the third intubation attempt using a pediatric laryngoscope and proper positioning, the breathing tube placement is successful. There is a confirmation of breath sounds bilaterally along with end-tidal CO2 monitoring.

Scenario 3

How does PALS support responding to a pediatric emergency in an adolescent?

The morning had started normally for 13-year old track star Erin until she collapsed suddenly near the finish line at her track meet, unresponsive. The coach dialed 911 and initiated CPR while the athletic trainer hurried over with an AED from the school’s emergency preparedness kit.

Recognizing the signs of sudden cardiac arrest, the trainer placed the defibrillator pads on Erin’s chest, allowing the device to analyze the rhythm. Identifying ventricular fibrillation, the AED advised delivering a child-appropriate biphasic shock. After the jolt and 2 minutes of continued chest compressions, a pulse returned but Erin remained unconscious.

Paramedic EMTs arriving rapidly on-scene assumed management applying lessons from their PALS certification. Recognizing possible traumatic causes from the abrupt collapse, they stabilized Erin’s neck and back while assessing airway patency. A glucometer test ruled out hypoglycemia. The team provides high-quality CPR while establishing IV access and administering IV fluids to counteract hypoperfusion along with oxygen via Ambu bag.

On arrival in the pediatric emergency department, Erin was urgently evaluated by the medical team who identified normal glucose levels but high serum potassium consistent with hyperkalemic periodic paralysis – a condition that can cause sudden cardiac events in adolescents. Following PALS guidelines, the team provides calcium chloride to protect the heart along with other medications to drive potassium back into cells.

With the definitive diagnosis guiding supportive measures, Erin gets hemodynamic monitoring while in the PICU. Erin may still need extensive evaluation but the PALS training gave Erin the best possible chance at survival and full neurological recovery after an otherwise deadly presentation.


Whether it’s an infant, a toddler, or an adolescent, Pediatric Advanced Life Support cultivates the rapid assessment skills, medical knowledge, and clinical competence with pediatric patients needed when seconds count. When faced with the stress of ambiguous chief complaints, complex medical histories, guardian emotions running high, and a child’s survival on the line, online PALS certification for healthcare professionals equips healthcare teams to expertly stabilize the critical pediatric patient. 

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