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CPR2015 update: PBLS

CPR2015 update: Pediatric Basic Life Support

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CPR2015 update: PBLS

  1. 1. Pediatric BLS
  2. 2. Purposees of guidelines • Infant BLS : < 1 years • Child BLS : > 1 years – puberty (breast develop in female , axillary in male) • Adult BLS : > puberty
  3. 3. Topic reviewed in 2015 • C-A-B sequence • New algorithms for 1 rescuer and multiple rescuer pediatric HCP • Upper limit 6 cm for chest compression depth • Chest compression rate 100 – 120 /min • Confirm compression and ventilation are needed for pediatric BLS
  4. 4. High-quality CPR • Ensuring chest compressions of adequate rate • Ensuring chest compressions of adequate depth • Allowing full chest recoil between compression • Minimizing interruptions in chest compression • Avoid excessive ventilation
  5. 5. BLS sequence for lay rescuer • Safety of rescuer and victim • Assess need for CPR • Check for response : gently tap victim and ask loundly • Check for breathing – Regular breathing -> recovery position – Not breath/grasping -> start CPR • Start chest compression • Open the airway and give ventilations – Head tilt –chin lift maneuver in injured/non-injured victim – Mouth to mouth and nose ->mouth to mouth -> mouth to nose • Coordinate chest compression and breathing – Chest compression 30:2 breath • Activated emergency response system – 2 resucer : 1 CPR , 1 activated emergency response system – 1 rescuer : CPR first -> activated emergency response system
  6. 6. BLS sequence for HCP • Assess the need for CPR • Pulse check (10 sec) • Inadequate breathing with pulse -> give rescue breaths at rate 12 – 20 breaths/min (3-5 sec/breath) + reassure pulse every 2 min • Bradycardia with poor perfusion – HR < 60 bpm -> start CPR • Chest compression – 1 rescuer : 2 finger chest compression – 2 rescuer : 2 thumb
  7. 7. • Ventilation – head tilt –chin life – Spine injury -> jaw thrust • Co-ordinate chest compression and ventilation (minimal interruptions) – Non-advanced airway • 1 rescuer -> 30 : 2 • 2 rescuer -> 15 :2 – Advanced airway : • Chest compression : 100 – 120 compression / 2 min • Ventilation : 8 – 10 breath / min = 6-8 sec/breath BLS sequence for HCP
  8. 8. • Defibrillation : VF/pulseless VT ->manual defibrillation 2 J/kg -> 4 J/kg • Defibrillation sequence using an AED • Breathing adjunts – Barrier devices – Bag-mask ventilation(HCP) – Precaution : avoid excessive ventilation – 2-person Bag-mask ventilation – Gastric inflation and cricoid pressure – Oxygen : minimal FiO2 to keep O2sat 94% – O2 mask : non rebreathing mask with oxygen inflow 15 L/min – Nasal cannular : suitable for child with spontaneous breathing BLS sequence for HCP
  9. 9. • Foreign-body airway bstruction – Most common cause • Infants : liquid • Children : ballon , small objects and food – S&S : sudden onset of respiratory distress with coughing , gagging , stridor or wheezing – Relief of FBAO • Infant : 5 back blow , 5 chest thrust • Child : Heimlich maneuver BLS sequence for HCP
  10. 10. • Trauma – Anticipate airway obstruction – Stop all external bleeding with direct pressure – Suspect spine injury -> minimize motion of the cervical spine and movement of the head and neck BLS sequence for HCP
  11. 11. BLS – single rescuer
  12. 12. Multiple rescuer

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