Pediatric BLS: Difference between revisions
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==Goals of Resuscitation== | ==Goals of Resuscitation== | ||
The goal of resuscitation is to perform high- quality [[CPR]] and have a better neurological outcome post-discharge. | |||
'''High - quality CPR''' | |||
[[Cardiopulmonary resuscitation]] comprises of effective chest compression and [[ventilation]] by [[Rescue breathing|rescue breath]]. | |||
*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. | |||
**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 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> | |||
=== Variables with the good prognostic outcome<ref name="pmid26472853">{{cite journal| author=de Caen AR, Maconochie IK, Aickin R, Atkins DL, Biarent D, Guerguerian AM | display-authors=etal| title=Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. | journal=Circulation | year= 2015 | volume= 132 | issue= 16 Suppl 1 | pages= S177-203 | pmid=26472853 | doi=10.1161/CIR.0000000000000275 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26472853 }} </ref> === | |||
*Age >1 year | |||
*Shockable rhythm like [[ventricular fibrillation]] | |||
*Less duration of [[CPR]] | |||
*[[Pupillary reflex|Reactive pupil]] at 24 hours after [[ROSC]] | |||
*Lower serum [[lactate]] levels at 0 to 12 hours after [[ROSC]] is associated with improved outcomes. | |||
The following tables provide the details of the different studies done to determine which factors during pediatric cardiac arrest resuscitation have a superior prognosis.<ref name="pmid26472853">{{cite journal| author=de Caen AR, Maconochie IK, Aickin R, Atkins DL, Biarent D, Guerguerian AM | display-authors=etal| title=Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. | journal=Circulation | year= 2015 | volume= 132 | issue= 16 Suppl 1 | pages= S177-203 | pmid=26472853 | doi=10.1161/CIR.0000000000000275 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26472853 }} </ref> | |||
OHCA - Out of hospital cardiac arrest. | |||
ROSC- Return of spontaneous circulation. | |||
{| class="wikitable" | |||
|+Summary of studies for OHCA to determine age as a prognostic factor | |||
! | |||
! rowspan="2" |Age <1 year compared to >1 year | |||
! rowspan="2" |Author | |||
! rowspan="2" |Study details | |||
|- | |||
| rowspan="2" |30- Day survival with good neurological outcome | |||
|- | |||
|Good prognosis associated in children >1 year | |||
| Tetsuhisa Kitamura, MD <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> | |||
|Study group - 5158 Children (RR -2.4; 95% CI,1.7-3.4) | |||
|- | |||
|30-Day survival in age >1 year | |||
|Good prognosis associated in children >1 year | |||
| Tetsuhisa Kitamura, MD <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> | |||
|Study group- 5158 Children (RR- 1.5; 95% CI,1.3-1.8) | |||
|- | |||
| rowspan="3" |Survival to hospital discharge | |||
|Good prognosis associated in children >1 year | |||
|Dianne L. Atkins <ref name="pmid19273724">{{cite journal| author=Atkins DL, Everson-Stewart S, Sears GK, Daya M, Osmond MH, Warden CR | display-authors=etal| title=Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. | journal=Circulation | year= 2009 | volume= 119 | issue= 11 | pages= 1484-91 | pmid=19273724 | doi=10.1161/CIRCULATIONAHA.108.802678 | pmc=2679169 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19273724 }} </ref> | |||
|Study group- 621 Children (RR- 2.7; 95% CI,1.3-5.7) | |||
|- | |||
|Good prognosis associated in children >1 year | |||
|Kelly D. Young<ref name="pmid15231922">{{cite journal| author=Young KD, Gausche-Hill M, McClung CD, Lewis RJ| title=A prospective, population-based study of the epidemiology and outcome of out-of-hospital pediatric cardiopulmonary arrest. | journal=Pediatrics | year= 2004 | volume= 114 | issue= 1 | pages= 157-64 | pmid=15231922 | doi=10.1542/peds.114.1.157 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15231922 }} </ref> | |||
|Study group- 599 Children (RR- 1.3; 95% CI,0.8-2.1) | |||
|- | |||
|Good prognosis associated in children >1 year | |||
|Moler, Frank W. MD<ref name="pmid20935561">{{cite journal| author=Moler FW, Donaldson AE, Meert K, Brilli RJ, Nadkarni V, Shaffner DH | display-authors=etal| title=Multicenter cohort study of out-of-hospital pediatric cardiac arrest. | journal=Crit Care Med | year= 2011 | volume= 39 | issue= 1 | pages= 141-9 | pmid=20935561 | doi=10.1097/CCM.0b013e3181fa3c17 | pmc=3297020 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20935561 }} </ref> | |||
|Study group- 138 Children (RR- 1.4; 95% CI,0.8-2.4) | |||
|} | |||
{| class="wikitable" | |||
|+Summary of studies for OHCA to determine shockable rhythm vs non-shockable rhythm as a prognostic factor | |||
! | |||
!Shockable rhythm vs non-Shockable rhythm | |||
!Author | |||
!Study details | |||
|- | |||
|30- Day survival with good neurological outcome | |||
|Good prognosis with shockable rhythm like VF | |||
|Tetsuhisa Kitamura, MD <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> | |||
|Study group- 5170 Children (RR- 4.4; 95% CI,3.6-5.3) | |||
|- | |||
|30-Day survival | |||
|Good prognosis with shockable rhythm like VF | |||
|Tetsuhisa Kitamura, MD <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> | |||
|Study group- 5170 Children (RR- 9.0; 95% CI,6.7-12.3) | |||
|- | |||
| rowspan="2" |Survival to hospital discharge | |||
|Good prognosis with shockable rhythm like VF | |||
|Dianne L. Atkins <ref name="pmid19273724">{{cite journal| author=Atkins DL, Everson-Stewart S, Sears GK, Daya M, Osmond MH, Warden CR | display-authors=etal| title=Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. | journal=Circulation | year= 2009 | volume= 119 | issue= 11 | pages= 1484-91 | pmid=19273724 | doi=10.1161/CIRCULATIONAHA.108.802678 | pmc=2679169 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19273724 }} </ref> | |||
|Study group- 366 Children (RR- 4.0; 95% CI,1.8-8.9) | |||
|- | |||
|Good prognosis with shockable rhythm like VF | |||
|Moler, Frank W. MD<ref name="pmid20935561">{{cite journal| author=Moler FW, Donaldson AE, Meert K, Brilli RJ, Nadkarni V, Shaffner DH | display-authors=etal| title=Multicenter cohort study of out-of-hospital pediatric cardiac arrest. | journal=Crit Care Med | year= 2011 | volume= 39 | issue= 1 | pages= 141-9 | pmid=20935561 | doi=10.1097/CCM.0b013e3181fa3c17 | pmc=3297020 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20935561 }} </ref> | |||
|Study group- 138 Children (RR- 2.7; 95% CI,1.3-5.6) | |||
|} | |||
==Approach to Suspected Patient of Cardiac or Respiratory Arrest== | ==Approach to Suspected Patient of Cardiac or Respiratory Arrest== | ||
Revision as of 09:35, 11 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Neepa Shah, M.D.
Synonyms and keywords:
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)[1]
- 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.[2]
Classification
- Pediatric Basic Life Support is classified according to age[3]
- Age - Less than 1 year - Infant Basic Life Support
- Age - 1 year to Puberty - Child Basic Life Support
- Age - After Puberty - Adult Basic Life Support
- BLS can be classified as
- BLS in Out of hospital cardiac arrest (OHCA)
- BLS inpatient cardiac arrest (IHCA)
Causes of Cardiac arrest(CA) in children
- Ventricular Fibrillation
- Pulseless Ventricular tachycardia
- Children with preexisting cardiac disorders
- Drug intoxication (eg, tricyclic antidepressants, digoxin, cocaine)
- Commotio cordis [4]
References
- ↑ Naim MY, Burke RV, McNally BF, Song L, Griffis HM, Berg RA; et al. (2017). "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". JAMA Pediatr. 171 (2): 133–141. doi:10.1001/jamapediatrics.2016.3643. PMID 27837587.
- ↑ Sahu S, Kishore K, Lata I (2010). "Better outcome after pediatric resuscitation is still a dilemma". J Emerg Trauma Shock. 3 (3): 243–50. doi:10.4103/0974-2700.66524. PMC 2938489. PMID 20930968.
- ↑ 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.
- ↑ Ralston.M.E (2020).Pediatric basic life support for healthcare providers. In James F Wiley (Ed.), UpToDate. Retrieved from https://www.uptodate.com/home
References
Goals of Resuscitation
The goal of resuscitation is to perform high- quality CPR and have a better neurological outcome post-discharge.
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]
Variables with the good prognostic outcome[4]
- Age >1 year
- Shockable rhythm like ventricular fibrillation
- Less duration of CPR
- Reactive pupil at 24 hours after ROSC
- Lower serum lactate levels at 0 to 12 hours after ROSC is associated with improved outcomes.
The following tables provide the details of the different studies done to determine which factors during pediatric cardiac arrest resuscitation have a superior prognosis.[4] OHCA - Out of hospital cardiac arrest. ROSC- Return of spontaneous circulation.
Age <1 year compared to >1 year | Author | Study details | |
---|---|---|---|
30- Day survival with good neurological outcome | |||
Good prognosis associated in children >1 year | Tetsuhisa Kitamura, MD [5] | Study group - 5158 Children (RR -2.4; 95% CI,1.7-3.4) | |
30-Day survival in age >1 year | Good prognosis associated in children >1 year | Tetsuhisa Kitamura, MD [5] | Study group- 5158 Children (RR- 1.5; 95% CI,1.3-1.8) |
Survival to hospital discharge | Good prognosis associated in children >1 year | Dianne L. Atkins [6] | Study group- 621 Children (RR- 2.7; 95% CI,1.3-5.7) |
Good prognosis associated in children >1 year | Kelly D. Young[7] | Study group- 599 Children (RR- 1.3; 95% CI,0.8-2.1) | |
Good prognosis associated in children >1 year | Moler, Frank W. MD[8] | Study group- 138 Children (RR- 1.4; 95% CI,0.8-2.4) |
Shockable rhythm vs non-Shockable rhythm | Author | Study details | |
---|---|---|---|
30- Day survival with good neurological outcome | Good prognosis with shockable rhythm like VF | Tetsuhisa Kitamura, MD [5] | Study group- 5170 Children (RR- 4.4; 95% CI,3.6-5.3) |
30-Day survival | Good prognosis with shockable rhythm like VF | Tetsuhisa Kitamura, MD [5] | Study group- 5170 Children (RR- 9.0; 95% CI,6.7-12.3) |
Survival to hospital discharge | Good prognosis with shockable rhythm like VF | Dianne L. Atkins [6] | Study group- 366 Children (RR- 4.0; 95% CI,1.8-8.9) |
Good prognosis with shockable rhythm like VF | Moler, Frank W. MD[8] | Study group- 138 Children (RR- 2.7; 95% CI,1.3-5.6) |
Approach to Suspected Patient of Cardiac or Respiratory Arrest
Algorithm
According to the AHA guidelines[3] [9]
- 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[3],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
Basic Life Support Guidelines (Revised American Heart Association 2010 Guidelines)
General Consideration
- ↑ 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.
- ↑ 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.
- ↑ 3.0 3.1 3.2 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.
- ↑ 4.0 4.1 de Caen AR, Maconochie IK, Aickin R, Atkins DL, Biarent D, Guerguerian AM; et al. (2015). "Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations". Circulation. 132 (16 Suppl 1): S177–203. doi:10.1161/CIR.0000000000000275. PMID 26472853.
- ↑ 5.0 5.1 5.2 5.3 Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Nadkarni VM; et al. (2010). "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". Lancet. 375 (9723): 1347–54. doi:10.1016/S0140-6736(10)60064-5. PMID 20202679.
- ↑ 6.0 6.1 Atkins DL, Everson-Stewart S, Sears GK, Daya M, Osmond MH, Warden CR; et al. (2009). "Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest". Circulation. 119 (11): 1484–91. doi:10.1161/CIRCULATIONAHA.108.802678. PMC 2679169. PMID 19273724.
- ↑ Young KD, Gausche-Hill M, McClung CD, Lewis RJ (2004). "A prospective, population-based study of the epidemiology and outcome of out-of-hospital pediatric cardiopulmonary arrest". Pediatrics. 114 (1): 157–64. doi:10.1542/peds.114.1.157. PMID 15231922.
- ↑ 8.0 8.1 Moler FW, Donaldson AE, Meert K, Brilli RJ, Nadkarni V, Shaffner DH; et al. (2011). "Multicenter cohort study of out-of-hospital pediatric cardiac arrest". Crit Care Med. 39 (1): 141–9. doi:10.1097/CCM.0b013e3181fa3c17. PMC 3297020. PMID 20935561.
- ↑ Marino BS, Tabbutt S, MacLaren G, Hazinski MF, Adatia I, Atkins DL; et al. (2018). "Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease: A Scientific Statement From the American Heart Association". Circulation. 137 (22): e691–e782. doi:10.1161/CIR.0000000000000524. PMID 29685887.