I'm not proud to admit this but I failed PALS twice before finally passing last month. The first time I walked in way too confident — I'd done ACLS a couple years ago and figured it couldn't be that different. Wrong. The pediatric rhythms and weight-based dosing completely threw me off during the megacode stations. Second attempt I crammed the algorithms the night before like I was back in nursing school. Also wrong.
What actually worked the third time was giving myself three weeks and being really systematic about it. I used a PALS practice test every single morning before my shift — doing practice questions daily helped me recognize patterns instead of just memorizing charts. I also found a study guide that broke down the H's and T's specifically for peds, which I'd been glossing over before.
Curious if anyone else struggled with the respiratory distress vs. respiratory failure distinction? That tripped me up constantly. Also the shock algorithms — compensated vs. decompensated. Happy to share what finally clicked for me if anyone's prepping right now.