4 In contrast to cardiac arrest in adults, cardiac arrest in infants and children is rarely a sudden event, and non-cardiac causes predominate. Sudden cardiopulmonary arrest in infants and children is much less common than sudden cardiac arrest in adults. The Chain of Survival integrates education in prevention of cardiopulmonary arrest, BLS, early access to EMS systems prepared for children’s needs, early and effective pediatric ALS, and pediatric postresuscitation and rehabilitative care (Figure 1 ). The population addressed in this chapter includes infants from birth to 1 year of age and children from 1 to 8 years of age.ĬPR and life support in the pediatric age group should be part of a community-wide Chain of Survival that links the child to the best hope of survival following emergencies. Pediatric BLS refers to the provision of CPR, with no devices or with bag-mask ventilation or barrier devices, until advanced life support (ALS) can be provided.
Teaching of cardiopulmonary resuscitation skills must be simplified, and courses must be skill-based and outcome driven. Critical elements for data collection have been described by an international consensus process, the Pediatric Utstein Guidelines for Reporting Outcome of Pediatric Cardiopulmonary Arrest. Data collection efforts should use consistent terminology and record important time intervals. 2 There is insufficient data to guide recommendations for pediatric resuscitation. There is a need for more and better data regarding the epidemiology, treatment, and outcome of pediatric cardiopulmonary arrest. Lone rescuers should “phone first” (phone EMS before beginning CPR) after the sudden collapse of a child with a known history of heart disease. Lay rescuers should be taught exceptions to the age-based sequence of resuscitation, which may include the following: -Lone rescuers should “phone fast” (provide immediate rescue breathing and other steps of CPR before phoning the EMS system) when submersion victims of any age are rescued from the water. Highlights of the pediatric resuscitation section of the International Guidelines 2000 are as follows:Īn etiology-based sequence for resuscitation was considered, but the age-based sequence (“phone fast” for infants and children, “phone first” for children >8 years old and adults) was retained (Class Indeterminate). Changes expected to simplify CPR teaching were encouraged. As a result, all potential science changes were evaluated with respect to their effect on the complexity of teaching. Multiple studies have documented poor skills retention by participants of traditional BLS courses and improved skills retention when course information is simplified. The initial sequence of BLS interventions in the pediatric Chain of Survival continues to be based on the most common etiology of arrest for a given age group, with modifications encouraged for special resuscitation circumstances.
Pediatric BLS guidelines detail specific modifications of adult techniques necessary to address anatomic, physiological, etiologic, and psychosocial issues for infants and children. 1 The new guidelines continue to emphasize prevention of cardiac arrest. Customer Service and Ordering InformationĬhanges in the pediatric section of the International Guidelines 2000 generally represent qualifications and refinements rather than major paradigm shifts from the 1992 Guidelines.
0 kommentar(er)
