PALS Pediatric Tachycardia Management — free guideline decision tool
This tool applies the AHA PALS tachycardia algorithm, choosing between synchronized cardioversion, adenosine and antiarrhythmics by hemodynamic stability and QRS width, with weight-based doses.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Weight (to calculate doses) | 15 kg |
|---|---|
| Hemodynamics | Unstable (hypotension/altered mental status/shock) |
| QRS width | Narrow QRS (≤ 0.09 s, mostly SVT/sinus tachycardia) |
→ManagementSynchronized cardioversion
- Management：Unstable (with a pulse) → immediate synchronized cardioversion: 0.5–1 J/kg = 7.5–15 J, escalate to 2 J/kg = 30 J if ineffective (sedation should not delay cardioversion)
- May concurrently：If access is established and it will not delay cardioversion, narrow-regular QRS may try adenosine 0.1 mg/kg = 1.5 mg first
- Basis：AHA PALS tachycardia with a pulse and poor perfusion algorithm
| Weight (to calculate doses) | 15 kg |
|---|---|
| Hemodynamics | Stable |
| QRS width | Wide QRS (> 0.09 s, suspected VT) |
→ManagementAmiodarone/procainamide
- Management：Wide QRS (suspected VT), stable → expert consultation; amiodarone 5 mg/kg = 75 mg IV (over 20–60 min) OR procainamide 15 mg/kg = 225 mg IV (over 30–60 min), do not combine the two (causes severe hypotension)
- Adenosine：Only if wide QRS is regular and monomorphic may consider adenosine 1.5 mg
- If unstable：Synchronized cardioversion 0.5–1 J/kg = 7.5–15 J → 2 J/kg = 30 J
Common questions
What is PALS Pediatric Tachycardia Management?
This tool applies the AHA PALS tachycardia algorithm, choosing between synchronized cardioversion, adenosine and antiarrhythmics by hemodynamic stability and QRS width, with weight-based doses.
How is PALS Pediatric Tachycardia Management calculated? What is the core formula?
Unstable (with a pulse) → synchronized cardioversion 0.5–1 J/kg → 2 J/kg. Stable narrow QRS (SVT) → vagal maneuvers → adenosine 0.1 mg/kg (max 6) → 0.2 mg/kg (max 12). Stable wide QRS (suspected VT) → expert consultation, amiodarone 5 mg/kg or procainamide 15 mg/kg.
When is PALS Pediatric Tachycardia Management used?
Use in a child with tachycardia to determine management by stability and QRS width and calculate cardioversion energy and drug doses.
What are the key clinical points for PALS Pediatric Tachycardia Management?
SVT is distinguished from sinus tachycardia by rate (infants often > 220, children > 180), absent rate variability and abnormal/absent P waves; sinus tachycardia is treated by addressing the cause. In unstable tachycardia, sedation should not delay synchronized cardioversion; adenosine may be tried only if it does not delay shock. Amiodarone and procainamide must not be combined for wide-complex tachycardia because of the risk of severe hypotension; expert consultation is advised.
What are the limits and cautions when using PALS Pediatric Tachycardia Management?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is PALS Pediatric Tachycardia Management calculated in practice? Can you show a worked example?
Inputs: Weight (to calculate doses) 15 kg, Hemodynamics Unstable (hypotension/altered mental status/shock), QRS width Narrow QRS (≤ 0.09 s, mostly SVT/sinus tachycardia) → Result: Management Synchronized cardioversion（Management: Unstable (with a pulse) → immediate synchronized cardioversion: 0.5–1 J/kg = 7.5–15 J, escalate to 2 J/kg = 30 J if ineffective (sedation should not delay cardioversion), May concurrently: If access is established and it will not delay cardioversion, narrow-regular QRS may try adenosine 0.1 mg/kg = 1.5 mg first, Basis: AHA PALS tachycardia with a pulse and poor perfusion algorithm） Inputs: Weight (to calculate doses) 15 kg, Hemodynamics Stable, QRS width Wide QRS (> 0.09 s, suspected VT) → Result: Management Amiodarone/procainamide（Management: Wide QRS (suspected VT), stable → expert consultation; amiodarone 5 mg/kg = 75 mg IV (over 20–60 min) OR procainamide 15 mg/kg = 225 mg IV (over 30–60 min), do not combine the two (causes severe hypotension), Adenosine: Only if wide QRS is regular and monomorphic may consider adenosine 1.5 mg, If unstable: Synchronized cardioversion 0.5–1 J/kg = 7.5–15 J → 2 J/kg = 30 J）
Run PALS Pediatric Tachycardia Management now
This tool applies the AHA PALS tachycardia algorithm, choosing between synchronized cardioversion, adenosine and antiarrhythmics by hemodynamic stability and QRS width, with weight-based doses.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.