Page 51 - 2023 SMOG Digital

Cardiac

PEDIATRIC ALS and BLS

INDICATORS
Indicators of Potential Need for Cardiopulmonary Support
• Breathing
o Irregular Respirations or >60 breaths/min
o Labored Breathing (Retractions, Nasal Flaring, Grunting, Pursing of Lips, Tripod Positioning, ↓Ability to
Speak)
• Heart Rate Ranges (especially if associated with poor perfusion)
o <2 Years Old: <80/min or >180/min
o >2 Years Old: <60/min or >160/min
• Poor Perfusion with Weak or Absent Distal Pulses
o Cyanosis
o ↓O2 Sat
• Altered Mental Status
o GCS <8, Weak Cry, Unusual Irritability, Altered Responsiveness, Lethargy, or Failure to Respond to Painful
Stimulus
• Seizures, Fever with Petechiae, Trauma, and/or Burns >10% Body Surface Area
IOT Prevent Cardiac Arrest You Must Detect and Treat:
Respiratory Failure / Respiratory Arrest / Shock
Pediatric Cardiac Arrest Results from Deterioration in Respiratory or Cardiac Function!
Heart Awake Sleeping Blood
Rate/Min Age Rate Mean Rate Pressure Average Lower Limit
Newborn to
3mo 85-205 140 80-160 1-10y 90+(years oldx2)mmHg 70+(years oldx2)mmHg
3mo - 2y 100-190 130 75-160 >10y 90mmHg
2 - 10y 60-140 80 60-90 MAP 55+(years oldx1.5)mmHg
>10y 60-100 75 50-90 Rescue Breathing Ventilation Rate Without Advanced Airway:

Respiratory Universal Patient Care • NEWBORN = 40–60/min when performed without compressions
Rate/Min Age Rate O2 (100% FiO2) • Infan t / Child = 1 breath/3–5 seconds

Infant 30-60 Monitor / Defibrillator
Toddler 24-40 IV/IO access (IV Protocol) CPR Rate of 100 Compressions / Min at:
Preschool 22-34 Unresponsive, Not • One Rescuer = 30 Compressions and 2 Breaths

• Two Rescuer = 15 Compressions and 2 Breaths
School 18-30 Breathing or ALS

Adolescent 12-16 Indicators Check Pulse (up to 10 sec)

DEFINITE Pulse Rapid Pulse with Rapid Pulse with poor Pulse <60/min with No Pulse?
good perfusion? perfusion despite O2 poor perfusion despite
and ventilation? O2 and ventilation?
• GIVE: 1 breath every 3–5 seconds PEDs Tachycardia Begin CPR and move to
• Ensure adequate oxygenation & with Pulse & appropriate protocol
ventilations Adequate Perfusion
• Recheck pulse every 2 minutes
o Add compressions if pulse <60/min PEDs Tachycardia PEDs Bradycardia Pediatric
despite O2 and ventilation with Pulse & Poor with Pulse & Poor Cardiac Arrest
o Move to appropriate guideline Perfusion Perfusion
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