Cardiac Arrest Flashcards
What are the signs of life
Response to stimuli
Normal breathing (rather than abnormal gasps)
Spontaneous movement
(NOT a pulse)
What are the causes of cardiopulmonary arrest in children
Most arrests arise from decompensated respiratory or circulatory failure, causing hypoxia
What are the initial management steps when a child is unconscious and not showing signs of life
- D - Ensure the safety of rescuer and child (Danger)
- R - Check responsiveness (stimulate and shout, slap feet if baby)
- Shout for help (999 or 2222)
- Turn the child onto their back and open the airway (head tilt, chin lift)
- second line: jaw thrust - Look/listen/feel for breathing (10 seconds max)
- Feel for a pulse (brachial/femoral in infants, femoral in children)
What should you state when calling for help
Population (Paediatric/Adult)
Type of arrest (Peri/Cardiac)
Location
Bed number, Ward, Floor, Building / Hospital
What is the head position you place the child in if they are <1yo
Neutral position
Describe CPR in children
- 5 rescue breaths (1s)
If no signs of life OR bradycardia <60bpm:
2. Chest compressions and rescue breaths 15:2
- 4cm for an infant - use a two-thumb technique
- 5cm for a child - may use one hand if small
- NEVER deeper than the adult 6cm limit
3. AED:
- <1yo: not recommended (manual defibrillation recommmended)
- >1-8yo:: use attenuator
- >7yo: follow prompts within 3 minutes of cardiac arrest confirmation
4. Adrenaline
- IV 10mcg/kg within 3 minutes of identification
- Every 3-5 minutes
When should CPR be stopped
There are signs of life e.g. normal breathing, cough, movement
Additional help arrives
You become exhausted
What are the signs of choking
Witnessed episode
Coughing or choking
Sudden onset
Recent history of playing with or eating small objects
What are the signs of ineffective coughing
Unable to vocalise
Quiet or silent cough
Unable to breathe
Cyanosis
Decreasing level of consciousness
What would indicate an effective cough
Crying or verbal response to questions
Loud cough
Able to take a breath before coughing
Fully responsive
What are the steps for managing a choking infant
- Shout for help
- If cough is effective → encourage cough
- Cough no effective → contact resuscitation team
- 5 back blows
- 5 chest thrusts
- cycle between 4 and 5
What are the steps for managing a choking child
- Shout for help
- If cough is effective → encourage cough
- Cough no effective → contact resuscitation team
- 5 back blows
- 5 abdominal thrusts
- cycle between 4 and 5
Describe back blows for choking in infants and children
Infant: head-downwards, prone position (across lap sitting down) - thumb of one hand at the angle of the lower jaw, and one or two fingers at the same point on the other side
Child: head down (place across lap or leaning forward)
5 back blows with the heel of one hand between the shoulder blades
Check if relieved after each blow
Describe chest thrusts for choking in infants
- Identify the landmark for chest compression (lower sternum approximately a finger’s breadth above the xiphisternum).
- Deliver up to 5 chest thrusts. These are similar to chest compressions, but sharper in nature and delivered at a slower rate.
- With two fingers from one hand at the landmark (baby in supine, head down position)
Describe abdominal thrusts used for choking in children
- Stand or kneel behind the child. Place your arms under the child’s arms and encircle their torso
- Clench your fist and place it between the umbilicus and xiphisternum. Grasp your fist with your other hand and pull sharply inwards and upwards. Repeat up to 4 more times.
- Ensure that pressure is not applied to the xiphoid process or the lower rib cage as this may cause abdominal trauma.
- The aim is to relieve the obstruction with each thrust rather than to give all 5 (hence may not require all 5 if successful).
