NRP vs PALS?

llg, PhD, RN · May 11, 2011

No. It doesn't. NRP content is very different -- geared for neonates and delivery room care.

Double-Helix, BSN, RN · May 11, 2011

Thanks. Can someone explain some of the specific skills from NRP that are NOT covered in PALS?

GilaRRT · May 11, 2011

You can research the NRP programme on the American Academy of Paediatrics website. NRP is broken into modules that focus on different topics. You can expect to discuss congenital defects and special management such as meconium aspiration and so on in the NRP course. The didactic portion can be completed online for about $30.00 or so and then you need only to find an instructor to validate your skills performance.

GreyGull · May 11, 2011

Meconium, LBW and premature handling specifics, UVC access, ethical issues for termination of resuscitation and viability to name a few.

punkydoodlesRN, BSN, RN · May 11, 2011

off the top of my head, I think the ratios are different for breaths, compressions. For NRP vs Pals (simply because of the age differences for the patients)

NRP is geared for the neonate - a fresh to extra-uterine life baby. I'm sure you would still use some PALS training, but for the most part, it's 4 steps. Asses, Supp 02, PP Vent, and then PP Vent with compressions, Epi/fluids.

The algorithm is much shorter :)

EricJRN, MSN, RN · May 11, 2011

A few examples:

There is a big difference in things like the ratio compressions to ventilations (3:1 for the neonate) and the rate for assisted ventilation (40-60/min).

PALS also doesn't emphasize differences between self-inflating BVM's (like the standard Ambu bags) and flow-inflating bags ("anesthesia bags"), both of which are in common use in delivery and neonatal settings.

Actually, you don't talk about management of the newly-born infant in the delivery room at all in PALS. A very common and very important scenario in the delivery room involves managing the meconium-stained infant. (The steps are much different depending on whether the infant is vigorous or not at delivery.) PALS would not discuss that at all.

PALS also doesn't cover any of the skills required to manage preterm neonates or babies with congenital anomalies. You won't talk about the essential steps in helping to thermoregulate a preemie (use of the radiant warmer and/or plastic bag). You won't learn the one critical exception to that rule that you should always bag-mask ventilate before intubation.

I teach both classes, love both classes and advocate for both classes. I think each class has a wealth of valuable information. PALS would definitely help build your confidence in resuscitating infants outside of the L&D setting, but it's not even a starting point for someone who would perform neonatal resuscitation as a job requirement.

(Oops... The last several posts didn't pop up for me before I posted. Sorry to be redundant!)

Esme12, ASN, BSN, RN · May 11, 2011

Thanks. Can someone explain some of the specific skills from NRP that are NOT covered in PALS?

Pals is pediactric babies (not newborn), toddler, children,.....NRP is neonate/newborn, premie....delivery room stuff.....check the website.

nfdfiremedic, BSN, RN · May 12, 2011

Depending on the field you're looking to enter, both may be recommended. In the ED, we require PALS only but staff are welcome to (and encouraged to) pursue NRP.

classicdame, MSN, EdD · May 12, 2011

OUr Pedi and Nursery nurses float between units sometimes. They must have BOTH PALS and NRP.

James Bond · Jul 21, 2013

Can anyone point me to some evidence that supports using NRP in lieu of PALS for the Pediatric ICU setting? We are being required to do this in our Pedi ICU even though we do not float or attend deliveries. I have been told it's because we have from newborns on up in our unit. By in large the majority of disease processes covered in NRP is related to delivery and stabilization. In one of the few studies I have seen there is virtualy no guidence in regards to this topic. You can see it here in PALS vs. NRP

Infant resuscitation outside the delivery room in neonatal-perinatal and pediatric critical care fellowship programs: NRP or PALS? Results of a national survey | DeepDyve

While all knowledge is worth something, the more of it you can use in every day life has a greater value.

That Guy, BSN, RN, EMT-B · Jul 22, 2013

I dont get why people want to do one or the other. Do them ALL. I have PALS,NRP, and ENPC. Each encompasses very different areas of care and are all great knowledge.