Advanced paediatric life support


These guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. They are not strict protocols, and they do not replace the judgement of a senior clinician. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline. 

Read the full PCH Emergency Department disclaimer.


To guide staff in the assessment and management of cardiorespiratory arrest.

Key Points

This guideline provides a refresher for the algorithms used in paediatric cardiorespiratory arrest. It is not a substitute for hands-on training courses such as the Advanced Paediatric Life Support course.


Cardiorespiratory arrest in children is less common than in adults. For this reason, all health care providers who work in paediatrics should regularly review Advanced Life Support algorithms to keep skills up to date.

Adequate basic life support must be in progress before commencing advanced life support algorithms.

Non shockable rhythms are more common than shockable rhythms in paediatric cardiorepsiratory arrest.


  • Ensure ABC issues are addressed as they are found.
  • Pause chest compressions briefly to analyse the cardiac rhythm.


  • Perform continuous CPR.
  • Follow non-shockable or shockable algorithm.
  • Minimise time off chest compressions.
  • Insert intraosseous needle if no venous access available.
  • Consider and address 4 Hs and 4 Ts.

Paediatric Advanced Life Support Algorithm


  1. Textbook of Paediatric Emergency Medicine 2nd Edition Cameron Elesevier
  2. Advanced Paediatric Life Support (APLS) 2017 Book 5th Edition
  3. Shann, F. Drug Doses (2010) 15th edition
  4. Paediatric & Neonatal Dosage Handbook 24th Edition Carol K. Taketomo, PharmD

Endorsed by:  Director, Emergency Department  Date:  Feb 2018

 Review date:   Feb 2021

This document can be made available in alternative formats on request for a person with a disability.