Pediatric Basic Life Support(BLS) Algorithm: Difference between revisions

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(/* Algorithm{{cite journal| author=Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW | display-authors=etal| title=Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation an...)
 
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==Overview==
==Overview==
Pediatric Basic Life Support is a life-saving skill comprising of high quality [[CPR (Cardiopulmonary Resuscitation)]] and Rescue Breadths with [[Artificial External Defibrillator (AED)]].  
Pediatric Basic Life Support is a life-saving skill comprising of high quality [[CPR (Cardiopulmonary Resuscitation)]] and Rescue Breadths with [[Artificial External Defibrillator (AED)]].  
* Bystander CPR - Bystander resuscitation plays a key role in out of hospital CPR. A study by Maryam Y Naim et all <ref name="pmid27837587">{{cite journal| author=Naim MY, Burke RV, McNally BF, Song L, Griffis HM, Berg RA | display-authors=etal| title=Association of Bystander Cardiopulmonary Resuscitation With Overall and Neurologically Favorable Survival After Pediatric Out-of-Hospital Cardiac Arrest in the United States: A Report From the Cardiac Arrest Registry to Enhance Survival Surveillance Registry. | journal=JAMA Pediatr | year= 2017 | volume= 171 | issue= 2 | pages= 133-141 | pmid=27837587 | doi=10.1001/jamapediatrics.2016.3643 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27837587 }} </ref> found out communities, where bystander CPR is practiced, have better survival outcomes in children less than 18 years from out of hospital cardiac arrest(CA)
* Bystander CPR - Bystander resuscitation plays a key role in out of hospital CPR. A study by Maryam Y Naim et all  found out communities, where bystander CPR is practiced, have better survival outcomes in children less than 18 years from out of hospital cardiac arrest(CA)


* Two studies (Total children 781) concluded that about half of the Cardio-Respiratory arrests in children under 12 months occur outside the hospital.
* Two studies (Total children 781) concluded that about half of the Cardio-Respiratory arrests in children under 12 months occur outside the hospital.
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**The short interval between arrest and arrival at the hospital.
**The short interval between arrest and arrival at the hospital.
**Less than 20 minutes of resuscitation in the emergency department.
**Less than 20 minutes of resuscitation in the emergency department.
**Less than 2 doses of epinephrine.<ref name="pmid20930968">{{cite journal| author=Sahu S, Kishore K, Lata I| title=Better outcome after pediatric resuscitation is still a dilemma. | journal=J Emerg Trauma Shock | year= 2010 | volume= 3 | issue= 3 | pages= 243-50 | pmid=20930968 | doi=10.4103/0974-2700.66524 | pmc=2938489 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20930968  }}</ref>
**Less than 2 doses of epinephrine.
 
==References==
==References==
<references />
<references />
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[[Category: (Pediatrics)]]
[[Category: (Pediatrics)]]


=Algorithm<ref name="pmid20956229">{{cite journal| author=Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW | display-authors=etal| title=Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2010 | volume= 122 | issue= 18 Suppl 3 | pages= S862-75 | pmid=20956229 | doi=10.1161/CIRCULATIONAHA.110.971085 | pmc=3717258 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20956229  }} </ref>=
=Algorithm=
*Look out for the safety of yourself as a bystander and the child/infant.
*Look out for the safety of yourself as a [[bystander]] and the child/infant.
*Call for help if alone and if 2 rescuers are present send one person to call the EMS (Emergency medical service) and get the AED(Automated external defibrillator).
*Call for help if alone and if 2 rescuers are present send one person to call the [[EMS]] (Emergency medical service) and get the [[AED]](Automated external defibrillator).
*Check for response ask "What is your name?" Can you hear me"
*Check for response ask "What is your name?" Can you hear me"
*Check if the child is breathing,
*Check if the child is breathing,
**If the child is breathing normally, don't do CPR.
**If the child is breathing normally, don't do [[CPR]].
**If the child is not breathing or is gasping for air start CPR
**If the child is not breathing or is gasping for air start CPR
*Check for a pulse in an infant it is the Brachial pulse. For children above 1 year of age check the Femoral artery pulse or the Brachial pulse, not more than 10 seconds.  
*Check for a pulse in an infant it is the Brachial pulse. For children above 1 year of age check the [[Femoral artery]] pulse or the [[Brachial artery|Brachial]] pulse, not more than 10 seconds.
*The new AHA guidelines in 2010<ref name="pmid20956229">{{cite journal| author=Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW | display-authors=etal| title=Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2010 | volume= 122 | issue= 18 Suppl 3 | pages= S862-75 | pmid=20956229 | doi=10.1161/CIRCULATIONAHA.110.971085 | pmc=3717258 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20956229  }} </ref>,2015 have changed the order from "ABC" Airway, Breathing/ventilation, and Chest compressions (or Circulation) to "CAB" Compression (Circulation) Airway and Breathing/Ventilation.
*The new [[AHA]] guidelines in 2010<ref name="pmid20956229">{{cite journal| author=Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW | display-authors=etal| title=Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2010 | volume= 122 | issue= 18 Suppl 3 | pages= S862-75 | pmid=20956229 | doi=10.1161/CIRCULATIONAHA.110.971085 | pmc=3717258 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20956229  }} </ref>,2015 have changed the order from "ABC" Airway, Breathing/ventilation, and Chest compressions (or Circulation) to "CAB" Compression (Circulation) [[Airway]] and Breathing/[[Ventilation]].
*High-quality chest compressions:
*High-quality chest compressions:
**For infants - Place 2 fingers below the intermammary line not compressing any rib or xiphoid process and start compressions 100/minute and up to 4 cm or 1.5-inch depth in infants and 5 cm or 2-inch depth in children above 1 year.  
**For infants - Place 2 fingers below the intermammary line not compressing any rib or [[xiphoid process]] and start compressions 100/minute and up to 4 cm or 1.5-inch depth in infants and 5 cm or 2-inch depth in children above 1 year.
**Use two hands wrapped around the thorax for better grip depending on the size of the child to avoid exhaustion especially if its a lone rescuer.
**Use two hands wrapped around the [[thorax]] for better grip depending on the size of the child to avoid [[exhaustion]] especially if its a lone rescuer.
**If 2 people are there give 15 chest compressions followed by 2 rescue breaths. Interchange the position every 2 minutes if 2 people are present to avoid exhaustion and ensure high-quality CPR.
**If 2 people are there give 15 chest compressions followed by 2 r[[Rescue breathing|escue breaths]]. Interchange the position every 2 minutes if 2 people are present to avoid exhaustion and ensure high-quality [[CPR]].
**If there is a single person for CPR give 30 chest compressions followed by 2 rescue breaths.  
**If there is a single person for [[CPR]] give 30 chest compressions followed by 2 [[Rescue breathing|rescue breaths]].
**CPR with rescue breaths has more survival benefit in children vs CPR- Only Compressions.  
**[[CPR]] with [[Rescue breathing|rescue breaths]] has more survival benefit in children vs CPR- Only Compressions.
**In children the majority of the cause for cardiac arrest is Asphyxia <ref name="pmid26472999">{{cite journal| author=Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL | display-authors=etal| title=Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2015 | volume= 132 | issue= 18 Suppl 2 | pages= S519-25 | pmid=26472999 | doi=10.1161/CIR.0000000000000265 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26472999  }} </ref>.
**In children the majority of the cause for [[Sudden cardiac death|cardiac arrest]] is [[Asphyxiation|Asphyxia]] .
**If the lone rescuer is not trained in ventilation then Compression only CPR can be done.
**If the lone rescuer is not trained in [[ventilation]] then Compression only [[CPR]] can be done.
*Ventilation
**If you are a lone rescuer, follow 30 x 2 cycle which is 30 compressions with 2 breaths. Observe for a chest rise as you are giving [[ventilation]].
**Use the head tilt and chin lift method to open the airway for injured and non-injured children.
**If there is no chest rise after mouth to mouth ventilation adjust the neck.
**Infants- Follow mouth to mouth ventilation, pinch the nose to prevent air movement out of the nose.
***Mouth to nose ventilation can also be administered, close the mouth to prevent air being lost in the mouth.
**Children- Follow Mouth to Mouth ventilation with pinching the nose.
**In each of the [[Rescue breathing|rescue breaths]] make sure the chest rises and quickly resume immediately compressions in 30 x 2 cycle if you are a lone rescuer for improving the survival.
<references />

Latest revision as of 08:35, 11 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Neepa Shah, M.B.B.S.[2]

Overview

Pediatric Basic Life Support is a life-saving skill comprising of high quality CPR (Cardiopulmonary Resuscitation) and Rescue Breadths with Artificial External Defibrillator (AED).

  • Bystander CPR - Bystander resuscitation plays a key role in out of hospital CPR. A study by Maryam Y Naim et all found out communities, where bystander CPR is practiced, have better survival outcomes in children less than 18 years from out of hospital cardiac arrest(CA)
  • Two studies (Total children 781) concluded that about half of the Cardio-Respiratory arrests in children under 12 months occur outside the hospital.
  • Good Prognostic Factor upon arrival at the emergency department-
    • The short interval between arrest and arrival at the hospital.
    • Less than 20 minutes of resuscitation in the emergency department.
    • Less than 2 doses of epinephrine.

References

Template:WH Template:WS

Algorithm

  • Look out for the safety of yourself as a bystander and the child/infant.
  • Call for help if alone and if 2 rescuers are present send one person to call the EMS (Emergency medical service) and get the AED(Automated external defibrillator).
  • Check for response ask "What is your name?" Can you hear me"
  • Check if the child is breathing,
    • If the child is breathing normally, don't do CPR.
    • If the child is not breathing or is gasping for air start CPR
  • Check for a pulse in an infant it is the Brachial pulse. For children above 1 year of age check the Femoral artery pulse or the Brachial pulse, not more than 10 seconds.
  • The new AHA guidelines in 2010[1],2015 have changed the order from "ABC" Airway, Breathing/ventilation, and Chest compressions (or Circulation) to "CAB" Compression (Circulation) Airway and Breathing/Ventilation.
  • High-quality chest compressions:
    • For infants - Place 2 fingers below the intermammary line not compressing any rib or xiphoid process and start compressions 100/minute and up to 4 cm or 1.5-inch depth in infants and 5 cm or 2-inch depth in children above 1 year.
    • Use two hands wrapped around the thorax for better grip depending on the size of the child to avoid exhaustion especially if its a lone rescuer.
    • If 2 people are there give 15 chest compressions followed by 2 rescue breaths. Interchange the position every 2 minutes if 2 people are present to avoid exhaustion and ensure high-quality CPR.
    • If there is a single person for CPR give 30 chest compressions followed by 2 rescue breaths.
    • CPR with rescue breaths has more survival benefit in children vs CPR- Only Compressions.
    • In children the majority of the cause for cardiac arrest is Asphyxia .
    • If the lone rescuer is not trained in ventilation then Compression only CPR can be done.
  • Ventilation
    • If you are a lone rescuer, follow 30 x 2 cycle which is 30 compressions with 2 breaths. Observe for a chest rise as you are giving ventilation.
    • Use the head tilt and chin lift method to open the airway for injured and non-injured children.
    • If there is no chest rise after mouth to mouth ventilation adjust the neck.
    • Infants- Follow mouth to mouth ventilation, pinch the nose to prevent air movement out of the nose.
      • Mouth to nose ventilation can also be administered, close the mouth to prevent air being lost in the mouth.
    • Children- Follow Mouth to Mouth ventilation with pinching the nose.
    • In each of the rescue breaths make sure the chest rises and quickly resume immediately compressions in 30 x 2 cycle if you are a lone rescuer for improving the survival.
  1. Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW; et al. (2010). "Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S862–75. doi:10.1161/CIRCULATIONAHA.110.971085. PMC 3717258. PMID 20956229.