Pediatric Basic Life Support(BLS) High-quality CPR: Difference between revisions
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=High- quality CPR= | =High- quality CPR= | ||
Cardiopulmonary resuscitation comprises of effective chest compression and ventilation by rescue breath. | Cardiopulmonary resuscitation comprises of effective chest compression and ventilation by rescue breath. | ||
*According to the AHA guidelines 2015,,2017,,2010 | *According to the AHA guidelines 2015,2017,2010,<ref name="pmid26472999">{{cite journal| author=Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL | display-authors=etal| title=Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2015 | volume= 132 | issue= 18 Suppl 2 | pages= S519-25 | pmid=26472999 | doi=10.1161/CIR.0000000000000265 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26472999 }} </ref><ref name="pmid29114009">{{cite journal| author=Atkins DL, de Caen AR, Berger S, Samson RA, Schexnayder SM, Joyner BL | display-authors=etal| title=2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2018 | volume= 137 | issue= 1 | pages= e1-e6 | pmid=29114009 | doi=10.1161/CIR.0000000000000540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29114009 }} </ref><ref name="pmid20956229">{{cite journal| author=Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW | display-authors=etal| title=Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2010 | volume= 122 | issue= 18 Suppl 3 | pages= S862-75 | pmid=20956229 | doi=10.1161/CIRCULATIONAHA.110.971085 | pmc=3717258 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20956229 }} </ref> the following are the steps for high-quality CPR. | ||
**Rate - Rate of CPR is the frequency of the chest compressions in a minute the AHA guidelines recommend 100 compressions per minute. | **Rate - Rate of CPR is the frequency of the chest compressions in a minute the AHA guidelines recommend 100 compressions per minute. | ||
**Depth- For high-quality CPR, the depth of the compressions should be 4 cm for infants and 5 cm for children more than 1 year of age. | **Depth- For high-quality CPR, the depth of the compressions should be 4 cm for infants and 5 cm for children more than 1 year of age. | ||
**Chest recoil- Allow the chest to recoil during chest compression which allows blood to flow back to the heart and hence the to the other vital organs. | **Chest recoil- Allow the chest to recoil during chest compression which allows blood to flow back to the heart and hence the to the other vital organs. | ||
**CPR with rescue breaths- The above guidelines suggest better neurological outcomes in children more than 1 year of age who were given CPR with the rescue breaths as compared to children who received Compression- only CPR for cardiac arrest<ref name="pmid26472999">{{cite journal| author=Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL | display-authors=etal| title=Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2015 | volume= 132 | issue= 18 Suppl 2 | pages= S519-25 | pmid=26472999 | doi=10.1161/CIR.0000000000000265 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26472999 }} </ref><ref name="pmid29114009">{{cite journal| author=Atkins DL, de Caen AR, Berger S, Samson RA, Schexnayder SM, Joyner BL | display-authors=etal| title=2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2018 | volume= 137 | issue= 1 | pages= e1-e6 | pmid=29114009 | doi=10.1161/CIR.0000000000000540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29114009 }} </ref><ref name="pmid20956229">{{cite journal| author=Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW | display-authors=etal| title=Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2010 | volume= 122 | issue= 18 Suppl 3 | pages= S862-75 | pmid=20956229 | doi=10.1161/CIRCULATIONAHA.110.971085 | pmc=3717258 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20956229 }} </ref>, | **CPR with rescue breaths- The above guidelines suggest better neurological outcomes in children more than 1 year of age who were given CPR with the rescue breaths as compared to children who received Compression- only CPR for cardiac arrest<ref name="pmid26472999">{{cite journal| author=Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL | display-authors=etal| title=Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2015 | volume= 132 | issue= 18 Suppl 2 | pages= S519-25 | pmid=26472999 | doi=10.1161/CIR.0000000000000265 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26472999 }} </ref><ref name="pmid29114009">{{cite journal| author=Atkins DL, de Caen AR, Berger S, Samson RA, Schexnayder SM, Joyner BL | display-authors=etal| title=2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2018 | volume= 137 | issue= 1 | pages= e1-e6 | pmid=29114009 | doi=10.1161/CIR.0000000000000540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29114009 }} </ref><ref name="pmid20956229">{{cite journal| author=Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW | display-authors=etal| title=Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2010 | volume= 122 | issue= 18 Suppl 3 | pages= S862-75 | pmid=20956229 | doi=10.1161/CIRCULATIONAHA.110.971085 | pmc=3717258 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20956229 }} </ref>,<ref name="pmid20202679">{{cite journal| author=Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Nadkarni VM | display-authors=etal| title=Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study. | journal=Lancet | year= 2010 | volume= 375 | issue= 9723 | pages= 1347-54 | pmid=20202679 | doi=10.1016/S0140-6736(10)60064-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20202679 }} </ref> | ||
Below I have summarised the evidence-based studies on which the new AHA guidelines are derived. | Below I have summarised the evidence-based studies on which the new AHA guidelines are derived. | ||
<references /> | <references /> | ||
Revision as of 14:48, 16 June 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Neepa Shah, M.B.B.S.[2]
Overview
Pediatric Basic Life Support is a life-saving skill comprising of high quality CPR (Cardiopulmonary Resuscitation) and Rescue Breadths with Artificial External Defibrillator (AED).
- Bystander CPR - Bystander resuscitation plays a key role in out of hospital CPR. A study by Maryam Y Naim et all found out communities, where bystander CPR is practiced, have better survival outcomes in children less than 18 years from out of hospital cardiac arrest(CA)
- Two studies (Total children 781) concluded that about half of the Cardio-Respiratory arrests in children under 12 months occur outside the hospital.
- Good Prognostic Factor upon arrival at the emergency department-
- The short interval between arrest and arrival at the hospital.
- Less than 20 minutes of resuscitation in the emergency department.
- Less than 2 doses of epinephrine.
References
High- quality CPR
Cardiopulmonary resuscitation comprises of effective chest compression and ventilation by rescue breath.
- According to the AHA guidelines 2015,2017,2010,[1][2][3] the following are the steps for high-quality CPR.
- Rate - Rate of CPR is the frequency of the chest compressions in a minute the AHA guidelines recommend 100 compressions per minute.
- Depth- For high-quality CPR, the depth of the compressions should be 4 cm for infants and 5 cm for children more than 1 year of age.
- Chest recoil- Allow the chest to recoil during chest compression which allows blood to flow back to the heart and hence the to the other vital organs.
- CPR with rescue breaths- The above guidelines suggest better neurological outcomes in children more than 1 year of age who were given CPR with the rescue breaths as compared to children who received Compression- only CPR for cardiac arrest[1][2][3],[4]
Below I have summarised the evidence-based studies on which the new AHA guidelines are derived.
- ↑ 1.0 1.1 Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL; et al. (2015). "Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S519–25. doi:10.1161/CIR.0000000000000265. PMID 26472999.
- ↑ 2.0 2.1 Atkins DL, de Caen AR, Berger S, Samson RA, Schexnayder SM, Joyner BL; et al. (2018). "2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 137 (1): e1–e6. doi:10.1161/CIR.0000000000000540. PMID 29114009.
- ↑ 3.0 3.1 Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW; et al. (2010). "Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S862–75. doi:10.1161/CIRCULATIONAHA.110.971085. PMC 3717258. PMID 20956229.
- ↑ Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Nadkarni VM; et al. (2010). "Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study". Lancet. 375 (9723): 1347–54. doi:10.1016/S0140-6736(10)60064-5. PMID 20202679.