First Responder EMS Curriculum for Training Centers in Eurasia

necessary to maintain optimal ventilation-perfusion relationships may be minimal. However, itdoes not appear that these observations can be applied to resuscitation of infants and children.Well-controlled animal studies have established that simulated bystander CPR with chestcompressions plus rescue breathing is superior to chest compressions alone or rescue breathingalone for asphyxial cardiac arrest and severe asphyxial hypoxic-ischemic shock (pulselesscardiac arrests). However, chest compression-only CPR and rescue breathing-only CPR havebeen shown to be effective early in animal models of pulseless arrest, and the application ofeither of these forms of "partial CPR" was found to be superior to no bystander CPR.Preliminary evidence suggests that both chest compressions and active rescue breathing arenecessary for optimal resuscitation of the asphyxial arrests most commonly encountered inchildren. For pediatric cardiac arrest, the lay rescuer should provide immediate chestcompressions and rescue breathing. If the lay rescuer is unwilling or unable to provide rescuebreathing or chest compressions, it is better to provide either chest compressions or rescuebreathing than no bystander CPR (Class IIb).370 First Responder EMS Curriculum/AIHA, July 2002