Basic Paediatric Life Support Guidelines 2005
Peter J. Safar 1924 – 2003
The European Resuscitation Council (ERC): Paediatric Life Support (PLS)  1994, 1998, 2000 International Liaison Committee ...
www.erc.edu
ERC Guidelines 2005 Better resuscitate as adult than doing nothing Strong focus on simplification  Chest compressions / ai...
Resuscitation of the child is different from adults. A lot of common in technique, but another starting point in children:...
Outcome of CPR in children:  3 – 17 % survival ,  survivors: severe neurological disability (80 %) Factors, which could af...
119 patients    18 years with cardiac arrest,  45 %    1 year, 64 %    3 years of age,  causes of cardiac arrest: Sudde...
<ul><li>Definitions (CPR point of view): </li></ul>Infant: < 1 year of age Child: 1 year – puberty
Paediatric Basic Life Support Algorithm
1. Ensure the  safety  of rescuer and child 2. Check the child’s  responsiveness: child with suspected cervical spinal inj...
Esmarch manoeuvre tilt head back lift chin
1. Ensure the safety of rescuer and child 3. Breathing Open airways <ul><li>Look – chest movements </li></ul><ul><li>Liste...
3. Breathing If the child is breathing      recovery position (lateral position, without obstruction of airways, free dra...
 
 
3. Breathing No chest movements    <ul><li>open the airways (Esmarch manoeuvre) </li></ul>Yes No <ul><li>foreign body obs...
 
4. Circulation <ul><li>pulse </li></ul>Yes No <ul><li>movement, coughing, breathing </li></ul>child: a.carotis infant: a.b...
4. Circulation   <ul><li>continue breathing </li></ul>Yes No is present   slow pulse (under 60/min)    is absent    not...
4. Circulation   <ul><li>lower third of sternum </li></ul>Yes No Infant <ul><li>rate 100 / min </li></ul><ul><li>compressi...
 
4. Circulation   <ul><li>lower third of sternum </li></ul>Yes No Child <ul><li>rate 100 / min </li></ul><ul><li>compressio...
 
<ul><li>the child shows signs  </li></ul><ul><li>of life (spontaneous  </li></ul><ul><li>breathing, pulse, movement) </li>...
   1 rescuer     one should start with CPR, another calls When to call for assistance 1 rescuer      perform CPR for 1 ...
Foreign-body airway obstruction Sudden onset of coughing, stridor or gagging
Foreign-body airway obstruction Infant <ul><li>hold the child in a prone position, head </li></ul><ul><li>lower than chest...
Foreign-body airway obstruction <ul><li>hold the child in a prone position, head </li></ul><ul><li>lower than chest </li><...
 
 
Foreign-body airway obstruction
 
www.erc.edu Basic  Paediatric Life Support Guidelines   2005
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FA: Pediatric

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FA: Pediatric

  1. 1. Basic Paediatric Life Support Guidelines 2005
  2. 2. Peter J. Safar 1924 – 2003
  3. 3. The European Resuscitation Council (ERC): Paediatric Life Support (PLS) 1994, 1998, 2000 International Liaison Committee on Resuscitation (ILCOR) + American Heart Association: ‘ Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care’ Paediatric Life Support Working Party of the European Resuscitation Council 2004 / 2005
  4. 4. www.erc.edu
  5. 5. ERC Guidelines 2005 Better resuscitate as adult than doing nothing Strong focus on simplification Chest compressions / air ventilation alone may improve outcome Many children receive no resuscitation at all because rescuers fear doing harm
  6. 6. Resuscitation of the child is different from adults. A lot of common in technique, but another starting point in children: Children – secondary cardiac arrest (non-cardiac origin) (hypoxia  respiratory failure  cardiac arrest) Adults – primary cardiac arrest (cardiac origin) (sudden, early defibrillation) Primary cardiac arrest in children  15 %
  7. 7. Outcome of CPR in children: 3 – 17 % survival , survivors: severe neurological disability (80 %) Factors, which could affect outcome of BLS: Recognition of condition, which can lead to cardiac arrest and properly performed BLS.
  8. 8. 119 patients  18 years with cardiac arrest, 45 %  1 year, 64 %  3 years of age, causes of cardiac arrest: Sudden infant death syndrome 32 % Epidemiology: Drowning 22 % Another respiratory diseases 9 % Congenital heart diseases 4 % Neurological diseases 4 % Oncological diseases 3 % Cardiological diseases 3 % Drug overdosage 3 % Smoke inhalation 2 % Anaphylaxis 2 % Endocrinological diseases 2 %
  9. 9. <ul><li>Definitions (CPR point of view): </li></ul>Infant: < 1 year of age Child: 1 year – puberty
  10. 10. Paediatric Basic Life Support Algorithm
  11. 11. 1. Ensure the safety of rescuer and child 2. Check the child’s responsiveness: child with suspected cervical spinal injuries should not be shaken stimulate + ask If the child responds by answering or moving  If the child does not respond  <ul><li>Leave the child in the position in which </li></ul><ul><li>you find him </li></ul><ul><li>Reassess him regularly </li></ul><ul><li>Shout for help </li></ul><ul><li>Open the child’s airway (tilt head and lift chin) </li></ul><ul><li>(Esmarch manoeuvre) </li></ul>
  12. 12. Esmarch manoeuvre tilt head back lift chin
  13. 13. 1. Ensure the safety of rescuer and child 3. Breathing Open airways <ul><li>Look – chest movements </li></ul><ul><li>Listen – breath sounds at child´s </li></ul><ul><li>nose and mouth </li></ul><ul><li>Feel – air movement on your cheek </li></ul>10 s for decision that breathing is absent 2. Responsiveness stimulate + ask
  14. 14. 3. Breathing If the child is breathing  recovery position (lateral position, without obstruction of airways, free drainage of fluid) <ul><li>5 slow breaths </li></ul>If the child is not breathing  <ul><li>1 – 1.5 s each </li></ul><ul><li>movement of chest </li></ul>1. Ensure the safety of rescuer and child Open airways Yes No 2. Responsiveness stimulate + ask
  15. 17. 3. Breathing No chest movements  <ul><li>open the airways (Esmarch manoeuvre) </li></ul>Yes No <ul><li>foreign body obstruction sequence </li></ul><ul><li>5 slow breaths </li></ul><ul><li>open the mouth, remove obstruction </li></ul>1. Ensure the safety of rescuer and child Open airways 2. Responsiveness stimulate + ask
  16. 19. 4. Circulation <ul><li>pulse </li></ul>Yes No <ul><li>movement, coughing, breathing </li></ul>child: a.carotis infant: a.brachialis within 10 s 1. Ensure the safety of rescuer and child Open airways 3. Breathing 2. Responsiveness stimulate + ask
  17. 20. 4. Circulation <ul><li>continue breathing </li></ul>Yes No is present  slow pulse (under 60/min)  is absent  not sure  <ul><li>chest compressions </li></ul><ul><li>breathing + </li></ul><ul><li>chest compressions </li></ul>1. Ensure the safety of rescuer and child Open airways 3. Breathing 2. Responsiveness stimulate + ask 2
  18. 21. 4. Circulation <ul><li>lower third of sternum </li></ul>Yes No Infant <ul><li>rate 100 / min </li></ul><ul><li>compression of sternum with </li></ul><ul><li>2 fingers to 1/3 of depth </li></ul><ul><li>of infant´s chest </li></ul><ul><li>1 rescuer: after 30 compressions 2 breaths </li></ul><ul><li>(ratio 30:2) </li></ul>1. Ensure the safety of rescuer and child Open airways 3. Breathing <ul><li>2 rescuers – ratio 15:2 </li></ul>2. Responsiveness stimulate + ask 2
  19. 23. 4. Circulation <ul><li>lower third of sternum </li></ul>Yes No Child <ul><li>rate 100 / min </li></ul><ul><li>compression of sternum </li></ul><ul><li>with arms straight to 1/3 </li></ul><ul><li>of depth of child´s chest </li></ul><ul><li>1 rescuer – ratio 30:2 </li></ul>1. Ensure the safety of rescuer and child Open airways 3. Breathing <ul><li>2 rescuers – ratio 15:2 </li></ul>2. Responsiveness stimulate + ask 2
  20. 25. <ul><li>the child shows signs </li></ul><ul><li>of life (spontaneous </li></ul><ul><li>breathing, pulse, movement) </li></ul>Continue resuscitation until <ul><li>qualified help arrives </li></ul><ul><li>rescuer become exhausted </li></ul>
  21. 26.  1 rescuer  one should start with CPR, another calls When to call for assistance 1 rescuer  perform CPR for 1 min before calling for assistance Only exeption: child with known heart disease
  22. 27. Foreign-body airway obstruction Sudden onset of coughing, stridor or gagging
  23. 28. Foreign-body airway obstruction Infant <ul><li>hold the child in a prone position, head </li></ul><ul><li>lower than chest </li></ul><ul><li>5 blows between shoulder blades </li></ul><ul><li>5 chest thrusts to the sternum </li></ul>
  24. 29. Foreign-body airway obstruction <ul><li>hold the child in a prone position, head </li></ul><ul><li>lower than chest </li></ul><ul><li>5 blows between shoulder blades </li></ul>Child <ul><li>5 abdominal thrusts (Heimlich manoeuvre) </li></ul>
  25. 32. Foreign-body airway obstruction
  26. 34. www.erc.edu Basic Paediatric Life Support Guidelines 2005

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