Child and infant BLS

Question 1

Primary cardiac arrest

Answer 1

-common in adults
-unpredictable onset
-often due to arrhythmia
-hypoxia and acidosis not initially present

Question 2

Secondary cardiac arrest

Answer 2

-most common form in children
-heart stops due to hypoxia and respiratory arrest
-commonly bradycardia progressing to asystole
-hypoxia present initially

Question 3

Preventing cardiac arrest in children

Answer 3

-early recognition of respiratory and or circulatory failure
-prevents progression to cardiac arrest

Question 4

Signs respiratory distress

Answer 4

-breathing rate increases (tachypnoea)
-HR increases (tachycardia)
-increased BP
-pallor (pale)
-intercostal recession
-nasal flaring

Question 5

Signs respiratory failure

Answer 5

-breathing rate decreases (bradypnoea)
-HR decreases (bradycardia)
-decrease level of response

Question 6

Circulatory failure pathway

Answer 6

-body goes into shock
-body able to compensate for fluid loss or redistribution
-compensating mechanisms begin to fail
-cell, tissue and organ death due to lack of perfusion
-this then leads to cardiac arrest

Question 7

Signs of shock

Answer 7

-pupil dilation
-confusion, aggression, drowsiness
-tachycardia
-tachypnoea
-thirst
-general weakness

Question 8

Age definitions

Answer 8

New born- neonate immediately after delivery
Neonate- infant within 28 days of being born
Infant- under 1
Child- between 1 and puberty

Question 9

Paediatric assessment triangle and features if in cardiac arrest

Answer 9

-appearance- floppy, lifeless
-work of breathing- none, agonal gasps
-circulation to skin- pale, grey, cyanosed

Question 10

Primary survey

Answer 10

-same as adult
CABC
-cat haem
-airway
-breathing
-circulation

Question 11

Sequence for assessment and treatment of child in cardiac arrest

Answer 11

-unresponsive
-open airway
-not breathing normally
-5 rescue breaths
-no signs life
-15 chest compressions
-then 15:2 ratio chest compressions to breaths

Question 12

Testing level of response

Answer 12

-verbal stimulation- use child’s name
-tactile stimulation- shake shoulder whilst supporting head, trapezium squeeze

Question 13

Opening infant airway

Answer 13

-ensure neutral head position and apply chin lift
-place something under their shoulders to minimise head tilt needed
-don’t push on soft tissue under chin as this may block airway

Question 14

Opening child airway

Answer 14

-head tilt chin lift
-same as adult but just slightly less flexion

Question 15

Where to check for pulse in infants and children

Answer 15

Infant- brachial artery
Child- carotid artery

Question 16

How to insert OPA

Answer 16

-avoid damaging hard and soft palates
-use tongue depressor or tip of laryngoscope
-no rotation of OPA

Question 17

Ventilations

Answer 17

-using BVM give 5 ventilations
-15l of oxygen
-allow 1 sec for chest rise and 1 sec chest fall
-look for signs of life
-if no signs commence chest compressions

Question 18

Chest compressions

Answer 18

-100-120 per min (same as adult)
-4cm depth for infant
-5cm depth for child (compress 1/3 of depth of chest)
-child only use one hand
-infant just use 2 fingers or can use thumbs using hands encircling technique
-older child use one or two hands to get correct depth

Question 19

When to use child AED pads

Answer 19

-if child is under 8
-follow adult guidelines if 8 years or over/ more than 25kg

Question 20

Defibrillation

Answer 20

-if required don’t delay
-shock
-minimise delays in CPR
-2 min intervals

Question 21

What to do if ROSC

Answer 21

-if HR below 60 continue CPR until arrive at hospital
-stop when told by more senior clinician