Version control: This document is current with respect to the latest 2016 American Heart Association® Guidelines for CPR and ECC. These guidelines are current until they are replaced on October 21, 2020. If you are reading this page after October 21, 2020, please contact ACLS Training Center at for an updated document.

In the adult sudden cardiac death caused by ventricular fibrillation is the most frequent cause of cardiac arrest. In infants and children cardiopulmonary arrest is most likely secondary to another condition such as respiratory failure or trauma causing hypovolemia. The primary assessment in pediatrics is very important because it is focused on catching issues that may lead to cardiac arrest before they do so.

The following should be assessed in all children who are suspected to have any grave illness.

  1. Abnormal Vital Signs (see Normal Vital Sign Chart)
  2. Irregular respirations
  3. Slow or fast heart rate for age
  4. Signs of poor perfusion
    1. Check for presence or absence of distal pulses
    2. Poor skin color
    3. Delayed capillary refill
  5. Cyanosis or Saturation less than 94%
  6. Altered level of consciousness for age
  7. Seizures
  8. Fever with petechiae
  9. Significant trauma
  10. Burns of >10% of body surface area

A positive answer to any of the above may indicate the need for cardiopulmonary support.