Pediatric BLS
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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]
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[5][3][6],
- ↑ 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.
- ↑ 3.0 3.1 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
- ↑ 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.
- ↑ 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.
References
Goals of Resuscitation
Approach to Suspected Patient of Cardiac or Respiratory Arrest
Basic Life Support Guidelines (Revised American Heart Association 2010 Guidelines)
General Consideration