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WHAT IS NEW
IN PEDIATRIC
CPR?
Abd El- Aal Elbahnasy,
MD
WHAT IS CPR ????.........
Cardio pulmonary resuscitation is a series of
steps used to establish artificial ventilation
and circulation in the patient who is not
breathing and has no pulse.
BLS for infant &children
Infant are less
than one year of
age (except
newborn)
Childern are
from one year to
puberty
WHEN YOU HAVE TO START CPR ????.......
1-No response
2-If the victim is not breathing
normally such as gasping for
breath or not breathing at all
3-No pulse
4- heart rate less than 60 beatm
American heart association new icon
‫؟‬
CHAIN OF SURVIVAL
Adult
CHAIN OF SURVIVAL
Pediatrics
What is new in pediatric cpr
STEPS OF CPR
1- Check the scene safety
2- Check for consciousness
3- check breathing &pulse
together
4- call for help
6- start chest compression
CHECK RESPONSE
• Gentle taping the foot of
baby
• And call him baby baby……
No response
Activate emergency response
• If the infant not respond
Immediately call for help
and get automated
external defibrillator
(AED)
pulse&Check breathing
• Look for chest rise
• Hear agonal breathing
• Check pulse in
brachial artery within
10 seconds
• Or pulse less than 60No breathing
Agonal breathing
No pulse or less than 60
Signs of poor perfusion
cool
extremitie
s
Altered
mental
status
Weak
Pulse
Skin : pale
mottling
then
cyanosis
Start compression
One rescuer
By two fingers at
lower 1|2 of breast
bone (sternum)
30 compression
to 2 breaths
Depth about 4 cm
Two rescuer
Encircle the chest
by both hands
15 compression to
2 breaths
Switch every 2
minutes or 10 cycle
Hand placement
 Infant:
compress the sternum with 2
fingers placed just below the inter-
mammary line
 Child:
compress the lower half of the
sternum at least one third of the AP
diameter of the chest (2 inches)
with one or two hands
 Note: do not compress over
the xiphoid or ribs
Compression depth
Infant at least one third of
A P diameter of chest
or about4 cm
Children at least one third
of A P diameter of chest
or about 5 cm
High quality C P R
Start chest compression within 10
second of recognition
Push hard about 4 cm, push fast from
100-120 compression in minute
Avoid interruption
Give effective breath
Avoid excessive ventilation
Count out loud
CPR FROM EGYPT TO GHANA
COUNTRY
Defibrillation
• Defibrillators are either
manual or automated (AED).
• AED can be used for infants
and children up to
approximately 25 kg (8 years
of age).
• In infants 1 year of age a
manual defibrillator is
preferred.
Paddle Size
Two sizes of hand-held paddle
“Adult” size : 8 to 10 cm for
children > 10 kg
( approximately 1 year)
“Infant” size :4-5 cm for
infants < 10 kg
Paddle Position:
Place over the right
side of the upper chest
and the apex of the
heart (to the left of the
nipple over the left
lower ribs) so the heart
is between the two
paddles.
 Apply firm pressure
Defibrillation sequence
Switch ON the device
Apply Paddles
Clear the patient for
analyzing the rhythm
Charging if shock
needed
Clear patients before
applying the shock
Continue CPR
DEFIBRRILATION
What is new in pediatric cpr
Manual Defibrillation Dosing
The recommended
first energy dose for
defibrillation is 2 J/kg.
If second dose is
required, it should be
doubled to 4 J/kg.
AED with pediatric
attenuator is preferred
for children < 8 years of
age.
What is new in pediatric cpr
What is new in pediatric cpr
If you heard “you will forgot”
If you saw “you will remember”
If you did “you will become
perfect”
SO you must practice
CPR
INFANT CPR WORKSHOP
TOMMORROW
friday
8:30 AM
AUDITRUM
HALL
What is new in pediatric cpr
What is new in pediatric cpr
Take home
message
Infant not small adult
C A B not A B C nothing delay compression
HIGH QUALITY C P R is mandatory
CPR is so easy only you want 2 hands &training
CPR before defibrillation improving outcome
You must follow the new guidlines
What is new in pediatric cpr

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What is new in pediatric cpr

  • 1. WHAT IS NEW IN PEDIATRIC CPR? Abd El- Aal Elbahnasy, MD
  • 2. WHAT IS CPR ????......... Cardio pulmonary resuscitation is a series of steps used to establish artificial ventilation and circulation in the patient who is not breathing and has no pulse.
  • 3. BLS for infant &children Infant are less than one year of age (except newborn) Childern are from one year to puberty
  • 4. WHEN YOU HAVE TO START CPR ????....... 1-No response 2-If the victim is not breathing normally such as gasping for breath or not breathing at all 3-No pulse 4- heart rate less than 60 beatm
  • 5. American heart association new icon ‫؟‬
  • 9. STEPS OF CPR 1- Check the scene safety 2- Check for consciousness 3- check breathing &pulse together 4- call for help 6- start chest compression
  • 10. CHECK RESPONSE • Gentle taping the foot of baby • And call him baby baby…… No response
  • 11. Activate emergency response • If the infant not respond Immediately call for help and get automated external defibrillator (AED)
  • 12. pulse&Check breathing • Look for chest rise • Hear agonal breathing • Check pulse in brachial artery within 10 seconds • Or pulse less than 60No breathing Agonal breathing No pulse or less than 60
  • 13. Signs of poor perfusion cool extremitie s Altered mental status Weak Pulse Skin : pale mottling then cyanosis
  • 14. Start compression One rescuer By two fingers at lower 1|2 of breast bone (sternum) 30 compression to 2 breaths Depth about 4 cm
  • 15. Two rescuer Encircle the chest by both hands 15 compression to 2 breaths Switch every 2 minutes or 10 cycle
  • 16. Hand placement  Infant: compress the sternum with 2 fingers placed just below the inter- mammary line  Child: compress the lower half of the sternum at least one third of the AP diameter of the chest (2 inches) with one or two hands  Note: do not compress over the xiphoid or ribs
  • 17. Compression depth Infant at least one third of A P diameter of chest or about4 cm Children at least one third of A P diameter of chest or about 5 cm
  • 18. High quality C P R Start chest compression within 10 second of recognition Push hard about 4 cm, push fast from 100-120 compression in minute Avoid interruption Give effective breath Avoid excessive ventilation Count out loud
  • 19. CPR FROM EGYPT TO GHANA COUNTRY
  • 20. Defibrillation • Defibrillators are either manual or automated (AED). • AED can be used for infants and children up to approximately 25 kg (8 years of age). • In infants 1 year of age a manual defibrillator is preferred.
  • 21. Paddle Size Two sizes of hand-held paddle “Adult” size : 8 to 10 cm for children > 10 kg ( approximately 1 year) “Infant” size :4-5 cm for infants < 10 kg
  • 22. Paddle Position: Place over the right side of the upper chest and the apex of the heart (to the left of the nipple over the left lower ribs) so the heart is between the two paddles.  Apply firm pressure
  • 23. Defibrillation sequence Switch ON the device Apply Paddles Clear the patient for analyzing the rhythm Charging if shock needed Clear patients before applying the shock Continue CPR
  • 26. Manual Defibrillation Dosing The recommended first energy dose for defibrillation is 2 J/kg. If second dose is required, it should be doubled to 4 J/kg. AED with pediatric attenuator is preferred for children < 8 years of age.
  • 29. If you heard “you will forgot” If you saw “you will remember” If you did “you will become perfect” SO you must practice CPR
  • 33. Take home message Infant not small adult C A B not A B C nothing delay compression HIGH QUALITY C P R is mandatory CPR is so easy only you want 2 hands &training CPR before defibrillation improving outcome You must follow the new guidlines