Topics Discussed: cardiology; cardiopulmonary resuscitation.
Sections: Cardiopulmonary Resuscitation: Introduction, The Importance of Incorporating High-Quality Basic Life Support into Advanced Life-Support Measures, Airway and Ventilation, Vascular Access Priorities for Medication Administration, A Systematic Approach to Arrest and Prearrest Dysrhythmias, Paroxysmal Supraventricular Tachycardia, Ventricular Tachycardia (with a Pulse), Asystole and PEA, Special Etiologies of Cardiopulmonary Arrest and Postresuscitation Considerations, References.
- Primary cardiac arrest is rare in children. Early recognition and prompt treatment of respiratory distress and shock are essential to prevent the progression to cardiopulmonary arrest.
- High-quality cardiopulmonary resuscitation (CPR) must be integrated into advanced life-support measures in order to ensure a good outcome during resuscitation. The code leader must therefore continually monitor the quality of chest compressions during the entire resuscitation.
- When two or more health care providers are performing CPR in an infant or child the correct compression to ventilation ratio is 15:2 (15 compressions followed by 2 ventilations). In all other circumstances, the new universal 30:2 compression to ventilation ratio should be used.
- Minimizing interruptions of chest compressions provides for better myocardial perfusion during CPR. Two-minute cycles of CPR should be performed before stopping compressions to reassess the child.
- Automated external defibrillators can be safely and effectively used in children older than 1 year. If at all possible a pediatric attenuator device should be used if the automated external defibrillator is being used in a child younger than 8 years of age or less than 25 kg.
- Overzealous ventilations via an advanced airway can impede venous return to the heart and thus potentially decrease cardiac output during CPR.
- Ventricular fibrillation and pulseless ventricular tachycardia..."
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