Paediatric BLS

Question 1

How is the anatomy of children different to an adult in relation to a arrest?

Answer 1

Airway - narrower, floppier, funnel shaped till age 8yrs, larger tongue,
Large head

Question 2

How is the physiology of children different to adults in relation to arrest?

Answer 2

Small resting lung volume = low oxygen reserve
New born blood circulating volume 80ml/Kg - low reserve

Question 3

Why is it hard to assess neurological status of a child?

Answer 3

Variable development / communication skills

Question 4

How is the situation of arrest typically different in children that adults?

Answer 4

Children - usually endpoint of prolonged period of decline, secondary to other causes (typically respiratory)
Leads to poorer outcome as lower baseline - majority die
Associated with greater acidosis, circulatory impairment and end organ damage.

Question 5

What cardiac arrest rhythms are more common in children?

Answer 5

Pulseless electrical activity
Asystole

Question 6

What are the CPR guideliens for an unresposive, unconscious, abnormal breathing child?

Answer 6

5 rescue breaths - use bag mask ventilation with oxygen
15 chest compression (rate 100-120bpm and 1/3 chest depth around 5cm)
2 rescue breaths
Repeat for 1 minute then get AED (or continue if someone else bringing AED/help on the way)

Question 7

What head position should be used during head tilt chin life for an infant/child during BLS?

Answer 7

Infant - neutral position - forehead and chin inline.
Cild - sniffing the morning air - chin just above forehead

Question 8

How should mouth to mouth be performed on infants/children?

Answer 8

Give steady breath over 1 second
<1yr - cover nose and mouth
>1yr pinch nose closed

Question 9

What is the method of chest compression in children/infants?

Answer 9

Infants = 4cm
Children = 5cm
Encircling technique is preferred
Two finger technique may also be used if single rescuer

Question 10

What is the typical energy level of a paediatric AED?

Answer 10

Energy reduced to 50-75 Joules

Question 11

What is the method of approaching choaking in a child/infant?

Answer 11

If effective cough - encourage
If ineffective cough AND
Conscious - Infant 5 back blows and 5 chest thrusts
Child - 5 back blows and 5 abdominal thrusts

Unconscious - start CPR