Pediatric Basic Life Support(BLS) High-quality CPR: Difference between revisions

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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==
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=High- quality CPR=
=High- quality CPR=
Cardiopulmonary resuscitation comprises of effective chest compression and ventilation by rescue breath.
[[Cardiopulmonary resuscitation]] comprises of effective chest compression and [[ventilation]] by [[Rescue breathing|rescue breath]].
*According to the AHA guidelines 2015,<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>,2017,<ref name="pmid29114009">{{cite journal| author=Atkins DL, de Caen AR, Berger S, Samson RA, Schexnayder SM, Joyner BL | display-authors=etal| title=2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2018 | volume= 137 | issue= 1 | pages= e1-e6 | pmid=29114009 | doi=10.1161/CIR.0000000000000540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29114009  }} </ref>,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> the following are the steps for high-quality CPR.
*According to the [[American Heart Association|AHA]] guidelines 2015,2017,2010, the following are the steps for [[CPR|high-quality CPR]].
**Rate - Rate of CPR is the frequency of the chest compressions in a minute the AHA guidelines recommend 100 compressions per minute.
**[[Rate]] - Rate of [[CPR]] is the frequency of the chest compressions in a minute the [[AHA]] guidelines recommend 100 compressions per minute.
**Depth- For high-quality CPR, the depth of the compressions should be 4 cm for infants and 5 cm for children more than 1 year of age.
**Depth- For high-quality [[CPR]], the depth of the compressions should be 4 cm for infants and 5 cm for children more than 1 year of age.
**Chest recoil- Allow the chest to recoil during chest compression which allows blood to flow back to the heart and hence the to the other vital organs.
**Chest recoil- Allow the chest to recoil during chest compression which allows [[blood]] to flow back to the [[heart]] and hence the to the other vital organs.
**CPR with rescue breaths- The above guidelines suggest better neurological outcomes in children more than 1 year of age who were given CPR with the rescue breaths as compared to children who received Compression- only CPR for cardiac arrest<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>,2017,<ref name="pmid29114009">{{cite journal| author=Atkins DL, de Caen AR, Berger S, Samson RA, Schexnayder SM, Joyner BL | display-authors=etal| title=2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2018 | volume= 137 | issue= 1 | pages= e1-e6 | pmid=29114009 | doi=10.1161/CIR.0000000000000540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29114009  }} </ref>,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><ref name="pmid20202679">{{cite journal| author=Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Nadkarni VM | display-authors=etal| title=Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study. | journal=Lancet | year= 2010 | volume= 375 | issue= 9723 | pages= 1347-54 | pmid=20202679 | doi=10.1016/S0140-6736(10)60064-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20202679  }} </ref>,
**[[CPR]] with [[Rescue breathing|rescue breaths]]- The above guidelines suggest better [[Neurology|neurological complications]] in children more than 1 year of age who were given [[CPR]] with the [[Rescue breathing|rescue breaths]] as compared to children who received Compression- only CPR for [[Sudden cardiac death|cardiac arrest]]<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><ref name="pmid29114009">{{cite journal| author=Atkins DL, de Caen AR, Berger S, Samson RA, Schexnayder SM, Joyner BL | display-authors=etal| title=2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2018 | volume= 137 | issue= 1 | pages= e1-e6 | pmid=29114009 | doi=10.1161/CIR.0000000000000540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29114009  }} </ref><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>,
Below I have summarised the evidence-based studies on which the new AHA guidelines are derived.
 
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Latest revision as of 15:20, 10 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

High- quality CPR

Cardiopulmonary resuscitation comprises of effective chest compression and ventilation by rescue breath.

  • According to the AHA guidelines 2015,2017,2010, the following are the steps for high-quality CPR.
    • Rate - Rate of CPR is the frequency of the chest compressions in a minute the AHA guidelines recommend 100 compressions per minute.
    • Depth- For high-quality CPR, the depth of the compressions should be 4 cm for infants and 5 cm for children more than 1 year of age.
    • Chest recoil- Allow the chest to recoil during chest compression which allows blood to flow back to the heart and hence the to the other vital organs.
    • CPR with rescue breaths- The above guidelines suggest better neurological complications in children more than 1 year of age who were given CPR with the rescue breaths as compared to children who received Compression- only CPR for cardiac arrest[1][2][3],


  1. Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL; et al. (2015). "Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S519–25. doi:10.1161/CIR.0000000000000265. PMID 26472999.
  2. Atkins DL, de Caen AR, Berger S, Samson RA, Schexnayder SM, Joyner BL; et al. (2018). "2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 137 (1): e1–e6. doi:10.1161/CIR.0000000000000540. PMID 29114009.
  3. 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.