Part 12: Pediatric Advanced Life Support

Caen, Allan R. de; Berg, Marc D.; Chameides, Leon; Gooden, Cheryl K.; Hickey, Robert W.; Scott, Halden F.; Sutton, Robert M.; Tijssen, Janice A.; Topjian, Alexis; Jagt, Élise W. van der; Schexnayder, Stephen M.; Samson, Ricardo A.

doi:10.1542/peds.2015-3373f

Cited by 104 publications

(137 citation statements)

References 95 publications

Supporting

Mentioning

134

Contrasting

Unclassified

Order By: Relevance

“…The 2015 ERC guidelines recommend to perform CC to the depth of 5-6 cm in adults, and to 1/3 of the sagittal thorax height in children [1,2]. Numerous studies indicate that performing manual CC without the use of supportive systems does not provide the optimum compressions depth.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Does the use of a chest compression system in children improve the effectiveness of chest compressions? A randomised crossover simulation pilot study

et al. 2016

View full text Add to dashboard Cite

A b s t r a c tBackground: Providing high-quality chest compressions is a key element affecting the effectiveness of cardiopulmonary resuscitation (CPR). Aim:To evaluate the effectiveness of standard (manual) chest compressions (Standard BLS, standard basic life support) and those performed with the use of the Lifeline ARM chest compression system (ARM; Defibtech). Methods:The study was designed as a randomised crossover study. In total, 37 nurses participated in the study. They performed a randomized 2-min asynchronous resuscitation using the Standard BLS method or the ARM system. The following parameters were measured: the total number of chest compressions, the frequency of compressions (min -1 ), compression depth (mm), and the percentage of correctly performed chest compressions and total chest decompressions. The authors also analysed the participants' preferences concerning the use of particular CPR techniques in the clinical setting. Results:The results obtained during the simulation study with the application of the ARM system were statistically significantly better than those with the Standard BLS method (p < 0.05) in the case of all analysed parameters.Conclusions: During the simulated child resuscitation performed by the nurses, the application of the Lifeline ARM chest compression system significantly improved the effectiveness of chest compressions.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The guidelines of the European Resuscitation Council (ERC), as well as the American Heart Association, put considerable emphasis on the quality of cardiopulmonary resuscitation (CPR) [1,2]. Both in adult and child CPR, the quality of chest compressions (CC) plays a crucial role in the survival of patients with sudden cardiac arrest (SCA).…”

Section: Introductionmentioning

confidence: 99%

Does the use of a chest compression system in children improve the effectiveness of chest compressions? A randomised crossover simulation pilot study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…4 Although adenosine is the most widely used abortive therapy for infantile SVT, vagal maneuvers, including carotid massage, facial cooling, ice water immersion, direct eyeball pressure, and the Valsalva maneuver for older children, are considered first-line if the infant is hemodynamically stable. 3,[11][12][13] If vagal maneuvers fail, adenosine is considered second-line, but it is contraindicated for irregular or polymorphic wide complex tachycardias because of the risk of conversion to ventricular fibrillation. 11,13,14 Last, if the infant is hemodynamically unstable, electrical cardioversion is recommended.…”

Section: Answermentioning

confidence: 99%

“…3,[11][12][13] If vagal maneuvers fail, adenosine is considered second-line, but it is contraindicated for irregular or polymorphic wide complex tachycardias because of the risk of conversion to ventricular fibrillation. 11,13,14 Last, if the infant is hemodynamically unstable, electrical cardioversion is recommended. 4,13 Paroxysmal SVT can be difficult to diagnose in infants, especially when the dysrhythmia has temporarily subsided.…”

Section: Answermentioning

confidence: 99%

See 1 more Smart Citation

An unexpected cause of infantile dyspnea

Nikolla

Carlson

2016

CJEM

View full text Add to dashboard Cite

A fully vaccinated 7-month-old male with no significant past medical history presented to the emergency department (ED) with his mother complaining of 3 days of worsening cough and tachypnea. His mother stated that he has begun belly-breathing and had significantly decreased oral intake over the past day. She denied fever, vomiting, diarrhea, rashes, lethargy, rhinorrhea, and wheezing.His vital signs were temperature of 36.1°C, heart rate (HR) of 130 beats/minute, respiratory rate (RR) of 60 breaths/minute, oxygen saturation of 94% on room air, and weight of 7.28 kg. He appeared to be in moderate distress with accessory muscle use. His head and neck examination was normal without stridor. For his age, he had a normal HR and rhythm without a murmur. He was tachypneic, but his lung sounds were clear of wheezes, rhonchi, and rales. His abdomen was soft without tenderness or masses. He had strong distal pulses, and his capillary refill was less than 2 seconds.His initial lab results were notable for a white blood cell count of 21.1 × 10 9

show abstract

Association of Early Postresuscitation Hypotension With Survival to Discharge After Targeted Temperature Management for Pediatric Out-of-Hospital Cardiac Arrest

et al. 2018

View full text Add to dashboard Cite

IMPORTANCE-Out-of-hospital cardiac arrest (OHCA) occurs in more than 6000 children each year in the United States, with survival rates of less than 10% and severe neurologic morbidity in many survivors. Post-cardiac arrest hypotension can occur, but its frequency and association with survival have not been well described during targeted temperature management.OBJECTIVE-To determine whether hypotension is associated with survival to discharge in children and adolescents after resuscitation from OHCA. DESIGN, SETTING, AND PARTICIPANTS-This post hoc secondary analysis of the Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA) trial included 292 pediatric patients older than 48 hours and younger than 18 years treated in 36 pediatric intensive care units from September 1, 2009, through December 31, 2012. Participants underwent therapeutic hypothermia (33.0°C) vs therapeutic normothermia (36.8°C) for 48 hours. All participants had hourly systolic blood pressure measurements documented during the initial 6 hours of temperature intervention. Hourly blood pressures beginning at the time of temperature intervention (time 0) were normalized for age, sex, and height. Early hypotension was defined as a systolic blood pressure less than the fifth percentile during the first 6 hours after temperature intervention. With use of forward stepwise logistic regression, covariates of interest (age, sex, initial cardiac rhythm, any preexisting condition, estimated duration of cardiopulmonary resuscitation [CPR], primary cause of cardiac arrest, temperature intervention group, night or weekend cardiac arrest, witnessed status, and bystander CPR) were evaluated in the final model. Data were analyzed from February 5, 2016, through June 13, 2017. EXPOSURES-Hypotension. MAIN OUTCOMES AND MEASURE-Survival to hospital discharge. RESULTS-Of 292 children (194 boys [66.4%] and 98 girls [33.6%]; median age, 23.0 months [interquartile range, 5.0-105.0 months]), 78 (26.7%) had at least 1 episode of early hypotension. No difference was observed between the therapeutic hypothermia and therapeutic normothermia groups in the prevalence of hypotension during induction and maintenance (73 of 153 [47.7%] vs 72 of 139 [51.8%]; P = .50) or rewarming (35 of 118 [29.7%] vs 19 of 95 [20.0%]; P = .10) during the first 72 hours. Participants who had early hypotension were less likely to survive to hospital discharge (20 of 78 [25.6%] vs 93 of 214 [43.5%]; adjusted odds ratio, 0.39; 95% CI, 0.20-0.74).CONCLUSIONS AND RELEVANCE-In this post hoc secondary analysis of the THAPCA trial, 26.7% of participants had hypotension within 6 hours after temperature intervention. Early post-cardiac arrest hypotension was associated with lower odds of discharge survival, even after adjusting for covariates of interest.Out-of-hospital cardiac arrest (OHCA) occurs in more than 6000 children each year in the United States, with survival rates of less than 10%. 1,2 After initial resuscitation from OHCA and admission to a pediatric intensive care unit, many children die ...

show abstract

Part 12: Pediatric Advanced Life Support

Cited by 104 publications

References 95 publications

Does the use of a chest compression system in children improve the effectiveness of chest compressions? A randomised crossover simulation pilot study

Does the use of a chest compression system in children improve the effectiveness of chest compressions? A randomised crossover simulation pilot study

An unexpected cause of infantile dyspnea

Association of Early Postresuscitation Hypotension With Survival to Discharge After Targeted Temperature Management for Pediatric Out-of-Hospital Cardiac Arrest

Contact Info

Product

Resources

About