PALS Pediatric Tachycardia Management — free guideline decision tool
Step-by-step PALS tachycardia pathway by QRS width and stability; cardioversion energy and drug doses follow PALS and local protocol.
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 | 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; energy per current PALS and local protocol. Sedation should not delay cardioversion.
- May concurrently：If access is established and it will not delay cardioversion, narrow-regular QRS may try adenosine first
- Basis：AHA PALS tachycardia with a pulse and poor perfusion algorithm
| Weight | 15 kg |
|---|---|
| Hemodynamics | Stable |
| QRS width | Wide QRS (> 0.09 s, suspected VT) |
→ManagementAmiodarone/procainamide
- Management：Wide QRS (suspected VT), stable → expert consultation; amiodarone OR procainamide as a slow IV infusion, do not combine the two (causes severe hypotension)
- Adenosine：Only if wide QRS is regular and monomorphic may consider adenosine
- If unstable：If the child becomes unstable, synchronized cardioversion; energy per current PALS and local protocol.
Common questions
What is PALS Pediatric Tachycardia Management?
Step-by-step PALS tachycardia pathway by QRS width and stability; cardioversion energy and drug doses follow PALS and local protocol.
How is PALS Pediatric Tachycardia Management calculated? What is the core formula?
Unstable (with a pulse) → synchronized cardioversion. Stable narrow QRS (SVT) → vagal maneuvers → adenosine. Stable wide QRS (suspected VT) → expert consultation, amiodarone or procainamide.
When is PALS Pediatric Tachycardia Management used?
Use in a child with tachycardia and a pulse: step-by-step management by stability and QRS width.
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.
Does PALS Pediatric Tachycardia Management upload patient data? Where is it calculated?
Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is PALS Pediatric Tachycardia Management calculated in practice? Can you show a worked example?
Inputs: Weight 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; energy per current PALS and local protocol. Sedation should not delay cardioversion., May concurrently: If access is established and it will not delay cardioversion, narrow-regular QRS may try adenosine first, Basis: AHA PALS tachycardia with a pulse and poor perfusion algorithm） Inputs: Weight 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 OR procainamide as a slow IV infusion, do not combine the two (causes severe hypotension), Adenosine: Only if wide QRS is regular and monomorphic may consider adenosine, If unstable: If the child becomes unstable, synchronized cardioversion; energy per current PALS and local protocol.）
Run PALS Pediatric Tachycardia Management now
Step-by-step PALS tachycardia pathway by QRS width and stability; cardioversion energy and drug doses follow PALS and local protocol.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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