The document outlines the basic life support (BLS) protocols for pediatric patients, emphasizing the importance of cardiopulmonary resuscitation (CPR) and the sequence of assessment, circulation, airway, and breathing. It details techniques for chest compressions and the use of automated external defibrillators (AED) for managing cardiac arrest and life-threatening arrhythmias in children. Post-resuscitation care is highlighted as crucial for optimizing tissue perfusion, particularly to the brain, within a 30-minute timeframe.

1. BASIC LIFE SUPPORT
DR. BIVEK KUMAR YADAV
PEDIATRIC RESIDENT FIRST YEAR

3. CONTENTS
 INTRODUCTION
 ASSESSMENT
 CIRCULATION
 AIRWAY
 BREATHING
 AUTOMED EXTERNAL DEFRILATTOR (AED)
 BLS ALGORITHM
 POST RESUSCITAION CARE
 REFERENCES

4. INTRODUCTION
 Cardiopulmonary arrest in children is much less common than
adults
 The major causes of death in infants and children
 Respiratory failure
 Sepsis
Neurologic disease
Drowning and injuries
Sudden infant death syndrome ( SIDS)

5. INTRODUCTION..
 Basic life support-A protocol mandatory in cases of
cardiopulmonary arrest providing cardiopulmonary
resuscitation (CPR) till advanced life support (ALS) can be
provided
 Two major objectives of cardiopulmonary resuscitation are:
1. To preserve organ viability
2. To help return spontaneous circulation

6. SEQUENCE OF BLS
 Assessment
 Circulation
 Airway
 Breathing

7. ASSESSMENT
 Done to look for the evidence of cardiac arrest
 Most accurate method of recognizing cardiac arrest;
combination of
 unresponsiveness
 absent or abnormal breathing
 In infants and children with no signs of life, health care providers
should begin CPR unless they definitely palpate a pulse within 10
seconds.

8. CHECK FOR RESPOSIVENESS
 Children

9.  Infant

10. CIRCULATION
 The CPR should begin with chest compression
 To provide optimum chest compression position should be
lying supine on a hard and flat surface
 High quality chest compressions should be given by
pushing hard, to a depth of at least one third the antero-
posterior dimension or approximately 1.5” (4cm) in infants
and 2” (5cm) in children

11. KEYS TO HIGH QUALITY CPR
 Push hard
 Push fast
 Minimize interruptions
 Allow full chest recoil
 Avoid excess ventilation

12.  Chest compression in
infants (<1 year)
1. Two thumb technique
Single rescuer 30:2
Two rescuer 15:2

13. 2. Two finger technique

14.  Chest compression in
children (1-8 years)
 Chest compression 30:2

15.  Chest compression for
children above 8 years
 100 to 120 chest
compression per minute
in infants, children and
adolescents

16. AIRWAY
 Infants and children are at higher risk of having
respiratory obstruction and failure due to the following
reasons:
- smaller size of upper airway
- large size of tongue
- smaller and compliant subglottic area
- relatively compliant chest wall and rib cage
- limited oxygen reserve

17.  Opening the airway:
1. Head tilt chin lift
maneuver:

18. 2. Jaw thrust maneuver:

19.  Foreign body airway
obstruction:
1. For infants: Back slaps

20.  Chest thrust

21. 2. For child or adolescent:
Heimlich manuever

22. BREATHING
 Check for breathing, periodic gasping also called
agonal gasp, is not breathing
 2 breaths every 2 to 3 seconds-(2020 AHA BLS Update)
 Infants: at least 30 breaths/min
 Older children: at least 25 breaths/min
 One should see the chest rise and fall to confirm
appropriate rescue breaths

23. SNIFFING POSITION

24. AUTOMATED EXTERNAL DEFRILATTOR
(AED)

25.  Defibrillation is the treatment for immediate life-
threatening arrthythmias in which patient does not have
a pulse such as ventricular fibrillation or pulseless
ventricular tachycardia.
 Initial shock: 2 joules/kg
 Second shock: 4 joules/kg
 Subsequent shock: >or= 4 joules/kg
 Maximum shock: 10 joules/kg

26. BLS ALGORITHM
SINGLE RESUER

27. BLS ALGORITHM
TWO OR MORE RESCUER

29. POST RESUSCITATION CARE
 Refers to a period between restoration of a spontaneous
circulation and transfer of patient to a healthcare facility
 This period should be less than 30 minutes (CRUCIAL
TIME)
 Immediate goal is to optimize tissue perfusion,
especially to the brain.

30. REFERENCES
 GHAI ESSENTAIL PEDATRICS
 American heart association (AHA) Guidelines 2020

31.  Special thanks:
-DR. Anita lammichhne
-DR. Uma Devi Chhetri