This document provides guidelines for pediatric resuscitation for infants and children. It outlines the steps for cardiopulmonary resuscitation including chest compressions at a rate of at least 100 per minute and a depth of at least 1/3 the anterior-posterior diameter of the chest. It also discusses ventilation techniques, the appropriate hand placement and compression-to-ventilation ratios for lone versus two rescuers. The document recommends pulse and respiratory checks, and calling for help as soon as possible when responding to a pediatric emergency.

2. N b N t l it tiNewborn
Infant: < 1 year
Neonatal resuscitation
Infant: < 1 year
Childhood: 1 year‐puberty
Breast development/axillary hair
AdultAdult
Pediatric Advanced Life Supportpp
Advanced Cardiac Life SupportAdvanced Cardiac Life Support

7. Rate at least 100/min
Depth at least 1/3 A P diameter Depth at least 1/3 A‐P diameter
(4 cm. for infant, 5 cm for children)
Complete recoil
Mi i i i iMinimize interruptions
Avoid excessive ventilationAvoid excessive ventilation

8. Nipple line for child pp
Below nipple line in infant

9. I f t l Infant: lone rescuer
2 fingers technique: just below intermammary line
I f t Infant: 2 rescuers
2 thumb encircling hand technique
ChildChild
Heel of 1 or 2 hands Lower half of sternum
R h l iRotate the compressor role every 2 minutes
Switch time < 5 seconds
Lone rescuer= 30: 2 ratio, 2 rescuers = 15: 2
PreferPrefer chest compression + ventilation >> compression p p
only

10. New recommendation : Bag & mask
ventilation : E‐C clamp ventilation : E C clamp
Give 2 breath chest move?
(12‐20 breath/min for child)(12‐20 breath/min for child)

11. Pulse check
Use brachial pulse < 1 yearUse brachial pulse < 1 year

12. Eti l f t C ll fi t VS C ll f tEtiology of arrest: Call first VS. Call fast
Respiratory
Cardiac arrhythmiaCardiac arrhythmia
Pulse check
Brachial ( ear)Brachial (< 1 year)
Carotid
Chest compression 1/3 chest wallChest compression 1/3 chest wall
Position and technique
For 1 rescuer: 30:2For 1 rescuer: 30:2
For 2 rescuers: 15:2

13. AED (>1 year)( y )
Manual defibrillator > AED Manual defibrillator > AED pedped dose attenuator > AEDdose attenuator > AED