Pediatric BLS

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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[1] 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

  1. 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.

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Causes of Cardiac arrest(CA) in children.

  • Ventricular Fibrillation
  • Pulseless Ventricular tachycardia
  • Children with preexisting cardiac disorders
    • Hypertrophic cardiomyopathy
    • Anomalous coronary artery (from the pulmonary artery)
    • Long QT syndrome
    • Myocarditis
  • Drug intoxication (eg, tricyclic antidepressants, digoxin, cocaine)
  • Commotio cordis [1]

References

  1. Ralston.M.E (2020).Pediatric basic life support for healthcare providers. In James F Wiley (Ed.), UpToDate. Retrieved from https://www.uptodate.com/home

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Classification

  • Pediatric Basic Life Support is classified according to age
    • 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

Pediatric Basic Life Support Guidelines (Revised American Heart Association 2019 Guidelines)

  • Pulse present but cannot breathe.
  • No Pulse and not breathing.



Changes made in the new AHA guidelines 2015

AED (Artificial External Defibrillator)

Airway management

Survival benefits of early high-quality CPR