Key management points
All pediatric pulseless cardiac arrest victims should receive AT LEAST excellent chest compressions to circulate blood, however rescue breathing by lay people or healthcare providers remains an important part of resuscitation for infants and children.
Data from the animal (piglet) and human (Japan) pediatric registry suggest that rescue breathing as part of first responder/bystander CPR for out-of-hospital pediatric cardiac arrest is important, and that both rescue breathing and chest compressions are important when the etiology of the arrest is not obviously cardiac (e.g., approximately 70% of pediatric out-of-hospital arrests).
The same principles as for adults (forceful thrust > 5 cm, rapid thrust > 100/minute, allow full chest recoil, minimize interruptions in chest compressions, and do not overventilate > 12/minute) apply malaysia email list to children.
As for adults, the quality of CPR is often suboptimal, and good quality CPR (deep, rapid, full release, minimal interruptions, no excessive ventilation) is associated with better outcomes after CPR.
Rapid recognition and shock delivery for electrocardiographic (VF/VT) rhythms is essential, with an initial energy dose of 2-4 J/kg. If there is no response to the basic CAB approach, look for and treat reversible causes of cardiac arrest.
Emergency management
Emergency management steps
First, establish unresponsiveness and lack of effective breathing. If pediatric cardiac arrest is established or strongly suspected, DO NOT DELAY. Yell for help and begin CPR with chest compressions in the center of the chest, with a compression/ventilation ratio of 30 compressions followed by two rapid breaths.
