European Resuscitation Council Guidelines for Resuscitation ... - CPR

18 de 0ctubre de 2010 www.elsuapdetodos.com1378 D. Biarent et al. / Resuscitation 81 (2010) 1364–1388Bystander CPR is associated with a better neurological outcomein adults and children. 277–279 The most common ECGpatterns in infants, children and adolescents with cardiopulmonaryarrest are asystole and PEA. PEA is characterised byorganised, wide or narrow complex electrical activity, usually(but not always) at a slow rate, and absent pulses. It commonlyfollows a period of hypoxia or myocardial ischaemia,but occasionally can have a reversible cause (i.e., one of the 4Hs and 4 Ts) that led to a sudden impairment of cardiac output.Fig. 6.10. Paediatric algorithm for non-shockable rhythm.Fig. 6.11. Paediatric algorithm for shockable rhythm.www.elsuapdetodos.comfor every minute delay in defibrillation (without any CPR), survivaldecreases by 7–10%. Survival after more than 12 min of VF in adultvictims is 50% survival. However, the success of defibrillationdecreases dramatically the longer the time until defibrillation:Adrenaline (epinephrine)Adrenaline is given every 3–5 min by the IV or IO route in preferenceto the tracheal tube route.Amiodarone in VF/pulseless VTAmiodarone is indicated in defibrillation-resistant VF/pulselessVT. Experimental and clinical experience with amiodarone in childrenis scarce; evidence from adult studies 236,285,286 demonstratesincreased survival to hospital admission, but not to hospital dis-