Pediatric Cardiac Arrest is Rare

Pediatric cardiac arrest is rare, occurring in approximately 16,000[1] children a year. Some medical professionals may go their entire career without responding to one, but those who have know it is one of the most stressful events you can face.

Pediatric Advanced Life Support (PALS) Guidelines were designed to be committed to memory and recalled under moments of stress. In addition to CPR quality, shock energy and advanced airway recommendations, PALS Guidelines specifically indicate the algorithm for drug therapy in a pediatric cardiac arrest:

  • Epinephrine IO/IV dose: 0.01 mg/kg
  • Amiodarone IO/IV dose: 5 mg/kg bolus during cardiac arrest
  • Lidocane IO/IV dose: 1 mg/kg loading dose

Unfortunately, resuscitation medications are currently only available in Bristoject syringes with a measured adult appropriate dose (1 mL). As providers perform mental math under extreme stress, it is possible for doses to exceed the recommended amount for pediatric patients by 10x. This is known as Death by Decimal Point.

Death by Decimal Point affects a staggering number of children each year. In fact, approximately 7,000 children die and 140,00 are injured due to critical dosing errors,[2] and studies show that critical dosing errors are three times more likely with pediatric patients than adults.[3]

How Often Do You Train for Pediatric Cardiac Arrest?

Medical providers that very rarely get called to a pediatric code may not be as comfortable with the PALS Guidelines as they would be handling an event they get called for multiple times a week. Current PALS methods rely on estimates and mental calculations to administer the correct dosing. As a result, the apprehension and stress could lead to potential errors leading to detrimental outcomes.

Certa Dose PALS Syringe Holder Kit

The Solution: Put PALS Guidelines at Your Fingertips

The Certa Dose PALS Syringe Holder Kit offers a visual aid that helps clinicians follow PALS Guidelines and alleviate the fear associated with a pediatric code. Color-coded syringe holders slip over commonly used Bristoject-style syringes to assist clinicians with accurate dosing. The color zones match the widely adopted Color Coding System for Weight. Studies show the color-coding approach improved dosing accuracy and therefore resulted in overall reduction in dosing errors.[4]

Each kit also provides a retractable length-based resuscitation tape for clinicians at all points of care to be confident during a pediatric code. PALS Guidelines state that tapes with precalculated doses printed at various lengths have been clinically validated and are more accurate than age-based or observer-estimate based methods in the prediction of body weight.[5]

Provide the best possible outcome for pediatric patients by keeping PALS Guidelines at your fingertips with the Certa Dose PALS Syringe Holder Kit.

To learn more about the Certa Dose® PALS Syringe Holder Kit, please call 888-891-1200 or email us to be connected to your local representative.

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[2, 4] Sears, K, et al. “The Relationship between the Nursing Work Environment and the Occurrence of Reported Paediatric Medication Administration Errors: A Pan Canadian Study.” Journal of Pediatric Nursing, U.S. National Library of Medicine,

[3] JAMA 2001; 285 (16) 2114-2120, slide 38