BNF for Children 2011-2012

PAEDIATRIC ADVANCED LIFE SUPPORTUnresponsive?Not breathing or only occasional gaspsCPR(5 initial breaths then 15:2)Attach defibrillator/monitorMinimise interruptionsCallResuscitation Team(1 min CPR first,if alone)Assess rhythmShockable(VF/pulseless VT)Non-shockable(PEA/Asystole)1 Shock4J / kgReturn ofspontaneouscirculationImmediately resumeCPR for 2 minMinimise interruptionsImmediate post cardiacarrest treatment• Use ABCDE approach• Controlled oxygenationand ventilation• Investigations• Treat precipitating cause• Temperature control• Therapeutic hypothermia?Immediately resumeCPR for 2 minMinimise interruptionsDuring CPR• Ensure high-quality CPR: rate, depth, recoil• Plan actions before interrupting CPR• Give oxygen• Vascular access (intravenous, intraosseous)• Give adrenaline every 3-5 min• Consider advanced airway and capnography• Continuous chest compressions whenadvanced airway in place• Correct reversible causesReversible causes• Hypoxia• Hypovolaemia• Hypo- / hyperkalaemia / metabolic• Hypothermia• Tension pneumothorax• Toxins• Tamponade - cardiac• ThromboembolismReproduced with the kind permission of the Resuscitation Council (UK) from Resuscitation Guidelines, October 2010