This chapter summarizes the changes contained in the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, published in the Decmber 13, 2005, issue of the American Heart Association journal Circulation, now also reviewed in 2008 and 2009. It highlights major changes and provides background information and detailed explanations. The etiologies of respiratory failure, shock, cardiopulmonary arrest and dysrhythmias in children differ from those in adults. In 1988, the American Heart Association implemented the pediatric advanced life support (PALS) program. Major revisions to the program were made in 1994, with further revisions in 1997. The PALS program teaches a systematic, organized approach for the evaluation and management of acutely ill or injured children. In 1983, the American Heart Association recommended the development of a course in pediatric advanced life support as a means of fulfilling the need for resuscitation guidelines and training specifically for children. In India, the first PALS courses were initiated under the auspices of the Indian Academy of Pediatrics in 1994, and are now a successful training course.