PALS is mostly about running pediatric codes, with some toxicology, shock, and respiratory failure thrown in. APLS focuses more on medical emergencies common to pediatric populations (which includes toxicology, shock, and respiratory failure, but others as well).
Key differences between ACLS and PALS:
As pointed out, there is more emphasis on respiratory failure and shock. Children don't tend to suffer primary arrhythmias the way that adults do, but die as a result of one of the above conditions. Toxicology also gets special attention.
Atropine is played down in infant populations for treating bradycardia because of potential of harming the developing parasympathetic system. The general rule in kids is that bradycardia = hypoxia, so ventilation with 100% O2 is treatment of choice. Atropine is, however, encouraged for premedication prior to intubation to prevent bradycardia.
High dose epi still shows up in some pediatric protocols, though is not really recommended (left to local protocol). It is absent from the adult protocols since it was shown to improve ROSC but have worse overall neurologic and cardiovascular outcomes.
Epi drips for bradycardia or shock are used in kids but very infrequently in adults.
CPR is performed on children with bradycardia refractory to ventilation, but not adults.
As others have said, drug dosages and defibrillation energy are weight-based.
Apart from the above differences, protocols are very similar between ACLS and PALS for tachycardia, v-fib, asystole, and PEA.
'zilla
