Pediatric emergencies present unique challenges that require specialized knowledge and skills. The Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS) program equips healthcare providers with the competencies necessary to assess, recognize, and stabilize critically ill or injured infants and children effectively. This article delves into the PEARS program, exploring its objectives, training components, and its role in improving pediatric emergency readiness.

PEARS Exam at a Glance

What changed for PEARS in 2026

• Oct 25, 2026: Delivery changed to Classroom, instructor-led (previously Classroom, instructor-led, through an AHA Training Center).^[1]
• Oct 25, 2026: Eligibility changed to Healthcare providers who infrequently see critically ill or injured infants and children (previously Healthcare providers who rarely see critically ill children).^[1]
• Oct 25, 2026: Number of questions changed to Video-based written exam plus 1- and 2-rescuer child BLS with AED and infant BLS skills tests (previously Video-based written exam plus child and infant BLS skills tests).^[1]
• Oct 25, 2026: Time limit changed to About 9 hours with breaks (course time) (previously About 9 hours with breaks).^[1]

According to American Heart Association, “Pass the skills tests in 1- and 2-rescuer child BLS with AED and 1- and 2-rescuer infant BLS”^[1]

Worked examples: how to reason through PEARS questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: After return of spontaneous circulation (ROSC) in a pediatric patient, what is the primary goal of post-resuscitation care?

1. Prevent re-arrest and optimize organ perfusion
2. Administer prophylactic antibiotics immediately
3. Perform a CT scan within 5 minutes
4. Discontinue all IV access

Answer: A. Prevent re-arrest and optimize organ perfusion

Explanation:

The correct answer is to prevent re-arrest and optimize organ perfusion. Getting a pulse back is not the finish line. The child is still unstable, and the care that follows aims to keep the heart beating and to deliver blood and oxygen to the brain and other organs so that secondary injury is limited.

Prophylactic antibiotics are not a routine immediate goal, and giving them does not address perfusion. A CT scan within 5 minutes is an arbitrary target, and it would pull attention away from monitoring and stabilization. Discontinuing IV access would remove the route you may need for fluids or medications if the child deteriorates again.

Rule to remember: after ROSC, keep reassessing and keep access, because the aim is to hold the child stable and well perfused.

Example 2

Question: A Broselow tape is used during a pediatric emergency primarily to:

1. Estimate weight-based medication doses and equipment sizes
2. Measure blood pressure
3. Determine IV fluid tonicity
4. Calculate oxygen flow rates manually

Answer: A. Estimate weight-based medication doses and equipment sizes

Explanation:

The correct answer is to estimate weight-based medication doses and equipment sizes. A Broselow tape is laid beside the child, and the child's length lines up with a color zone. That zone gives an estimated weight, pre-calculated drug doses and suitable equipment sizes, which saves time and reduces arithmetic mistakes under pressure.

It does not measure blood pressure, which needs a cuff and a monitor. It does not tell you the tonicity of an IV fluid, because that depends on the fluid itself. It is not used to calculate oxygen flow rates by hand, because oxygen delivery is set by the device and the child's condition.

Rule to remember: when you do not know a child's weight, length-based tools give you a fast, standardized starting point for doses and equipment.

Example 3

Question: Which physical finding best indicates successful relief of a foreign body airway obstruction in a conscious child?

1. Child stops crying and becomes calm
2. Effective cough returns with improved air entry
3. Heart rate decreases to normal range
4. Skin color returns from mottled to pink

Answer: B. Effective cough returns with improved air entry

Explanation:

The correct answer is that an effective cough returns with improved air entry. A conscious child with a foreign body airway obstruction cannot cough or move air well. When the object is dislodged, the child can cough forcefully and air moves in and out more freely. That is direct evidence the airway is open.

A child who stops crying and becomes calm may simply be tiring or getting worse, since a quiet child can be moving less air. A heart rate returning to the normal range is a general sign of stress easing and does not show the airway is clear. Skin color changing from mottled to pink is a perfusion sign and can lag behind or reflect other problems.

Rule to remember: judge airway relief by airway findings, meaning cough and air movement, not by behavior or vital signs alone.

How to use these practice tests

Start with the official material. Read the course page from the American Heart Association and any pre-course material your training center sends, so you know what the written exam and the skills tests cover.

1. Work through pediatric systematic assessment and the Pediatric Assessment Triangle set. Everything else depends on recognizing how sick a child is.
2. Move to recognizing respiratory emergencies, then managing them, followed by managing shock.
3. Practise cardiac arrest care, child and infant BLS and post-resuscitation care.
4. Finish with resuscitation team dynamics.

After each set, write down the questions you missed and the reason, then return to the course material for those topics. Repeat a set only after you have reviewed the explanations. Practise the BLS skills with a manikin when you can, since the skills tests are hands-on and reading will not replace that.

Key Takeaways

Free PEARS Practice Test Online

• PEARS is a vital training program that enhances healthcare providers' ability to assess, recognize, and stabilize pediatric emergencies.​

• The course is designed for professionals who may not specialize in pediatrics but are likely to encounter pediatric patients.​

• A systematic approach to pediatric assessment is crucial for early identification and intervention in critical situations.​

• National assessments reveal the importance of pediatric readiness in emergency departments and the role of designated coordinators in improving care quality.

Understanding Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS)

PEARS is a course developed by the American Heart Association (AHA) designed for healthcare providers who infrequently encounter pediatric emergencies. The program focuses on enhancing the ability to identify early signs of clinical deterioration in pediatric patients and to provide appropriate interventions to prevent further decline.

Key components of the PEARS course include:

• Systematic Pediatric Assessment: Training in a structured approach to evaluate pediatric patients, facilitating prompt recognition of critical conditions.​

• Recognition of Respiratory and Circulatory Issues: Identifying early indicators of respiratory distress, shock, and cardiopulmonary arrest in children.​

• Initial Stabilization Techniques: Implementing immediate interventions to stabilize pediatric patients until they can receive advanced care.

By completing PEARS training, healthcare providers enhance their preparedness to manage pediatric emergencies effectively, thereby improving patient outcomes.

What Is PEARS?

PEARS stands for Pediatric Emergency Assessment, Recognition, and Stabilization. It is an educational program aimed at healthcare professionals who do not specialize in pediatrics but may encounter pediatric patients in emergency situations. The course emphasizes the importance of early detection and intervention in pediatric emergencies to prevent progression to more severe conditions.

Pediatric Emergency Assessment

Effective pediatric emergency assessment is crucial for the timely identification of life-threatening conditions. The PEARS course trains participants in a systematic approach to pediatric assessment, which includes:​

• Initial Impression: Observing the child's appearance, work of breathing, and circulation to determine the severity of the condition.​

• Primary Assessment: Evaluating airway, breathing, circulation, disability (neurological status), and exposure (temperature and skin signs).​

• Secondary Assessment: Conducting a focused medical history and physical examination to gather more detailed information.​

• Tertiary Assessment: Utilizing diagnostic tests and monitoring to further assess the patient's condition.​

This structured approach ensures that healthcare providers can quickly identify and address critical issues in pediatric patients.

PEARS Training

PEARS training is designed to provide healthcare providers with the skills necessary to manage pediatric emergencies effectively. The course is suitable for a wide range of professionals, including:​

• Nurses​

• Emergency medical technicians (EMTs)

• Respiratory therapists​

• School-based healthcare providers​

• Outpatient clinic staff​

The training includes both theoretical knowledge and practical skills, covering topics such as:​

• Recognition and management of respiratory distress and failure​

• Identification and treatment of shock​

• Cardiopulmonary resuscitation (CPR) for infants and children​

• Effective communication and teamwork during pediatric emergencies​

Upon successful completion of the course, participants receive a PEARS provider certification, valid for two years.

National Assessment of Pediatric Readiness in Emergency Departments

The National Pediatric Readiness Project (NPRP) is an initiative aimed at improving the readiness of emergency departments (EDs) to provide high-quality care for pediatric patients. A national assessment conducted as part of this project evaluated EDs across the United States on their compliance with guidelines for pediatric care.

Key findings from the assessment include:​

• Presence of Pediatric Emergency Care Coordinators (PECCs): EDs with designated PECCs demonstrated higher levels of pediatric readiness and compliance with established guidelines. ​

• Variability in Readiness Scores: There was significant variability in pediatric readiness scores among EDs, highlighting the need for targeted improvements in certain areas.​

The NPRP emphasizes the importance of ongoing quality improvement initiatives to ensure that EDs are adequately prepared to care for pediatric patients.

Sources & last verified

1. American Heart Association — number of questions, time limit, passing score, validity (official source). “Pass the skills tests in 1- and 2-rescuer child BLS with AED and 1- and 2-rescuer infant BLS” Verified Oct 25, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.