🧒 PALS Pediatric Bradycardia Management
This tool applies the AHA PALS bradycardia algorithm, deciding between supportive care, CPR, epinephrine and atropine by heart rate, perfusion and cause, with weight-based doses.
PALS Pediatric Bradycardia Management
Weight (to calculate doses) (kg)
Heart rate and perfusion
Primary cause
When to use
Use in a child with symptomatic bradycardia to determine the next intervention and calculate epinephrine and atropine doses.
How it works
HR < 60 with poor perfusion despite adequate oxygenation/ventilation → CPR + epinephrine 0.01 mg/kg IV/IO q3–5 min; atropine 0.02 mg/kg (min 0.1, max 0.5 mg) only for increased vagal tone or AV block.
Key points
- The most common cause of pediatric bradycardia is hypoxia, so oxygenation and effective ventilation come first; CPR begins if HR < 60 with poor perfusion persists.
- Epinephrine is the first-line drug for hypoxic or shock-related bradycardia; atropine is reserved for increased vagal tone or AV block.
- Consider pacing for AV block or sinus-node dysfunction, and always search for reversible causes (hypoxia, hypothermia, acidosis, electrolytes, toxins, raised ICP).
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.