Code Blue Companion™

Paediatric resuscitation · PALS-based · v5.6.11

--:--next adrenaline
00:00
2:00reassess + swap
CPR in progress
CPR
WT
Reversible causes — 6 H's & 5 T's
Tap a cause to see what to check & do
The 6 H's
Hypoxia
Maximise oxygen. Confirm ETT position and bilateral air entry; ventilate effectively.
Hypovolaemia
IV/IO fluid bolus 10–20 mL/kg. Control haemorrhage; consider blood if bleeding.
Hydrogen ion (acidosis)
Ensure effective ventilation and treat the cause. Sodium bicarbonate only if prolonged arrest or known metabolic acidosis / hyperkalaemia.
Hypo / Hyperkalaemia & metabolic
Check ABG, electrolytes, glucose. Hyperkalaemia: calcium, bicarbonate, insulin–dextrose, salbutamol.
Hypoglycaemia
Check blood glucose. Give Dextrose 10% 5 mL/kg (0.5 g/kg) if glucose <60 mg/dL.
Hypothermia
Check core temperature. Active rewarming; continue resuscitation until warm ("not dead until warm and dead").
The 5 T's
Tension pneumothorax
Absent breath sounds, tracheal shift. Needle decompression (2nd ICS, mid-clavicular line), then chest drain.
Tamponade (cardiac)
Muffled heart sounds, distended neck veins. Echo if available; pericardiocentesis.
Toxins
Consider ingestion / overdose. Specific antidote (e.g. naloxone for opioids); call poison centre.
Thrombosis — pulmonary (PE)
Consider in sudden collapse with risk factors. Thrombolysis if strongly suspected.
Thrombosis — coronary
Rare in children; consider with cardiac history or Kawasaki disease.
MR SOPA — bag-mask ventilation not working
Mask seal · Reposition airway · Suction mouth/nose · Open mouth · Pressure increase · Airway (LMA/ETT)
DOPE — intubated patient suddenly deteriorates
Displacement of tube · Obstruction (secretions/kink) · Pneumothorax · Equipment failure (circuit, O₂, bag)

Rapid assessment

1 · Is the child responsive?
2 · Breathing?
3 · Central pulse (10 s max)?
kg
No weight? Estimate from age

CPR quality — coach every cycle

Rate 100–120/min
Depth ⅓ chest · 4cm inf / 5cm child
Recoil full, don't lean
Pauses < 10 s
Swap every 2 min
Ventilate don't over-ventilate

Code log

    Drugs Electricity Rhythm / assessment Airway / ROSC Status / guidance
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    Decision-support prototype, aligned with AHA PALS 2020/2025 & APLS weight estimates · v5.6.11 · created by Dr Vignesh N, PediaOS. A trained clinician must verify every dose before administration — this tool assists recall and calculation, it does not replace clinical judgment, and the treating clinician remains responsible for all decisions. Not affiliated with, or endorsed by, the American Heart Association or ALSG.
    Official guidelines: AHA PALS (cpr.heart.org) · IAP India — BLS/PALS (iapindia.org)
    © 2026 PediaOS (Dr Vignesh N). All rights reserved. “Code Blue Companion” · Not for reuse or redistribution without written permission. · About · Terms · Privacy

    ⚡

    Code Blue Companion™

    v5.6.11

    Paediatric resuscitation decision-support · 1 month–18 yr · PALS-based

    Created by Dr Vignesh N
    Pediatrician · Founder, PediaOS
    🏆 Medshark Champion — Best Pitch, ANBAI National Conclave 2026
    Disclaimer

    Code Blue Companion is a decision-support aid for trained clinicians during paediatric resuscitation. It performs weight-based dose calculations aligned with AHA PALS 2020/2025 and APLS estimates.

    A trained clinician must independently verify every dose, energy and calculation before administration. This tool assists recall and calculation only — it does not replace clinical judgment, is not a medical device, and does not diagnose or treat. The treating clinician remains fully responsible for all decisions.

    Scope: infants and children beyond the newborn period. Not for delivery-room or newborn (NRP) resuscitation, which uses different compression ratios and drugs.

    Do not enter patient-identifying information.

    Based on published AHA PALS and APLS guidance. Not affiliated with, or endorsed by, the American Heart Association or ALSG.

    Verify every dose before administration.

    By entering you agree to the Terms of Use and Privacy Policy.
    Decision-support aid · not for autonomous clinical use · © 2026 PediaOS™ (Dr Vignesh N)

    ⚡

    Code Blue Companion™

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    © 2026 PediaOS (Dr Vignesh N) · Decision-support aid · a trained clinician verifies every dose.