Pediatric Advanced Life Support

Publication Date: November 14, 2019


Bag-mask ventilation (BMV) is reasonable compared with advanced airway interventions (endotracheal intubation or SGA) in the management of children during cardiac arrest in the out-of-hospital setting.

Extracorporeal CPR (ECPR) may be considered for pediatric patients with cardiac diagnoses who have in-hospital cardiac arrest (IHCA) in settings with existing extracorporeal membrane oxygenation (ECMO) protocols, expertise, and equipment.

Continuous measurement of core temperature during targeted temperature management (TTM) is recommended.

For infants and children between 24 hours and 18 years of age who remain comatose after out-of-hospital cardiac arrest (OHCA) or IHCA, it is reasonable to use either TTM 32°C to 34°C followed by TTM 36°C to 37.5°C or to use TTM 36°C to 37.5°C.

Recommendation Grading




Pediatric Advanced Life Support

Authoring Organization

Publication Month/Year

November 14, 2019

Document Type


External Publication Status


Country of Publication


Document Objectives

This update provides the evidence review and treatment recommendations for advanced airway management in pediatric cardiac arrest, extracorporeal cardiopulmonary resuscitation in pediatric cardiac arrest, and pediatric targeted temperature management during post–cardiac arrest care.

Inclusion Criteria

Female, Male, Adolescent, Child, Infant

Health Care Settings

Childcare center, Emergency care, Hospital, Medical transportation, School

Intended Users

Paramedic emt, nurse, nurse practitioner, physician, physician assistant



Diseases/Conditions (MeSH)

D022561 - Advanced Cardiac Life Support


pediatric, acute respiratory failure, cardiac arrest, ACLS

Source Citation

2019 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Jonathan P. Duff, MD, MEd, Chair, Alexis A. Topjian, MD, MSCE, FAHA, Marc D. Berg, MD, Melissa Chan, MD, Sarah E. Haskell, DO, Benny L. Joyner Jr, MD, MPH, Javier J. Lasa, MD, S. Jill Ley, RN, MS, CNS, Tia T. Raymond, MD, FAHA, Robert Michael Sutton, MD, MSCE, Mary Fran Hazinski, RN, MSN, FAHA, Dianne L. Atkins, MD, FAHA