Pediatric Basic Life Support

Ch. 6

which technique is used for infant CPR

1-hand or 2 thumb–encircling hands

What is the recommended treatment for severe foreign body airway obstruction in an infant?

Repeated cycles of 5 back blows alternating with 5 chest thrusts

What is the recommended treatment for severe foreign body airway obstruction in a child?

Repeated cycles of 5 back blows alternating with 5 abdominal thrusts

What respiratory rate is recommended for infants and children who are receiving CPR with an advanced airway or receiving breaths with a pulse?

20–30 breaths per minute

Which maneuver is NOT recommended for infants with severe FBAO

Abdominal thrusts

FBAO

Foreign Body Airway Destruction

An unresponsive infant or child with abnormal breathing, including gasping, should receive what?

Emergency activation and high-quality CPR beginning with chest compressions

What is the foundation of resuscitation?

High-quality CPR

Which is a key component of high-quality CPR?

Minimizing interruptions

What should rescuers allow between chest compressions?

Complete chest recoil

What should rescuers avoid during high-quality CPR?

Excessive ventilation

What should a rescuer do if they cannot physically encircle an infant's chest?

Use the heel-of-1-hand technique

Why was the 2-finger technique eliminated from the 2025 AHA guidelines?

It was ineffective in achieving proper compression depth

When should an AED be attached to an infant or child in cardiac arrest?

As soon as possible

What should be used with an AED for an infant or child if available?

Pediatric attenuator and pediatric pads

Prompt defibrillation is critical for which rhythms?

Ventricular fibrillation and pulseless ventricular tachycardia

During defibrillation, what should be minimized?

Peri-shock pauses

pVT

pulseless ventricular tachycardia

What was the number of EMS-documented pediatric OHCA cases in 2015?

More than 7,000

What does IHCA stand for?

In-hospital cardiac arrest

How many infants and children have an IHCA per year in the United States?

More than 20,000

What does OHCA stand for?

Out-of-hospital cardiac arrest

What was pediatric IHCA survival to hospital discharge in 2022?

44.2%

Pediatric BLS guidelines exclude which group?

Newborn infants

What age group does the infant BLS guideline apply to?

Infants younger than approximately 1 year, excluding newborn infants

What age range does the child BLS guideline apply to?

1 year of age through puberty

When should adult BLS guidelines be followed?

When signs of puberty are present and beyond

For teaching purposes, what indicates puberty in males?

Axillary hair

Do pediatric BLS guidelines address newborn resuscitation?

no

What is considered the first year of life?

Infancy

What are the three states covered by the pediatric BLS guidelines?

Prearrest, intra-arrest, and postarrest

What is the usual primary cause of cardiac arrest in infants and children?

Progressive respiratory failure or shock

What usually precedes pediatric cardiac arrest?

A variable period of deterioration leading to cardiopulmonary failure, bradycardia, and cardiac arrest

Which rhythms are shockable with an AED?

VF and pVT

In children with congenital heart disease, cardiac arrest is often due to what?

A primary cardiac cause

What was pediatric IHCA survival to hospital discharge in 2000?

19%

What was the absolute increase in survival for in-hospital pulseless cardiac arrests from 2000 to 2018?

19%

Most pediatric OHCA are respiratory/asphyxial events leading to ____ and are thus____

Asystole or PEA; nonshockable rhythms

VF

Ventricular fibrillation

PEA

Pulseless electrical activity

Why have AEDs not produced large overall improvements in pediatric OHCA survival?

Shockable pediatric arrests are relatively rare

What percentage of patients with favorable outcomes had global cognitive impairment?

25% (one quarter)

What is critical when pediatric OHCA occurs?

Early lay responder CPR and availability of AEDs for shockable rhythms

What can post–cardiac arrest syndrome include?

Brain dysfunction, myocardial dysfunction, ischemia/reperfusion injury

What should be avoided after cardiac arrest to reduce secondary injury?

Hypotension

What is Step 1 of the Chain of Survival?

Recognition and emergency activation

What is Step 2 of the Chain of Survival?

High-quality CPR

What is Step 3 of the Chain of Survival?

Defibrillation (AED)

What is Step 4 of the Chain of Survival?

Advanced resuscitation

What is Step 5 of the Chain of Survival?

Post-cardiac arrest care

What is Step 6 of the Chain of Survival?

Recovery and survivorship

What is respiratory failure?

Breathing becomes inadequate, resulting in ineffective oxygenation and ventilation

Which of the following can cause respiratory failure?

Disordered control of breathing, airway obstruction, respiratory muscle failure, or parenchymal lung disease

What should be provided when breathing is absent or inadequate?

Assisted ventilation

What medication can be lifesaving in an opioid overdose?

Naloxone

Which interventions can be lifesaving in respiratory failure?

Assisted ventilation, relieving FBAO, and administering naloxone when indicated

asystole

complete absence of electrical activity; flatline

For infants and children with a pulse but absent or inadequate respiratory effort, it is reasonable to give __ breath every_ to_ seconds (20–30 breaths/min).

1;2;3

what is a major cause of cardiac arrest in infants and children

respiratory conditions

If infants or children w/severe FBAO become unresponsive, rescuers should start CPR, beginning with chest compressions… should rescuers perform a pulse check?

NO

should blind finger sweeps be performed for infants and children with FBAO?

NO

mild FBAO

patient is coughing and making sounds

severe FBAO

the patient cannot make sounds

Does clearing FBAO in children start with a series of back blows first or abdominal thrusts first?

back blows

for FBAO, after you start compressions, what should you do before giving breaths?

check for visible objects in mouth

When using an AED with adult pads on a child or infant, make sure the pads….

do not touch eachother

interruptions in CPR should be minimized, and pauses in chest compressions should be less than_____

10 seconds

If lay rescuers are unable or unwilling to deliver breaths to an infant or child in cardiac arrest, it is okay to…

provide compression-only CPR

chest compression rate

100 to 120 per minute

in infants and children, chest compressions should depress the chest at least ___ of its total thickness from front to back.

_cm in infants and _cm in children

1/3; 4; 5

It is reasonable to perform a rhythm check, lasting no more than___, approximately every _ min.

10 seconds; 2

longer duration of pauses at the end of CPR prior to cannulation for extracorporeal life support were associated with….

poor neurologic outcomes and lower survival

Is the use of 100% oxygen appropriate in CPR?

YES

true or false : shockable rhythms are rare in infants and children

true

the definitive treatment for VF/pVT is…

defibrillation

use of a pediatric attenuator is recommended for children less than __

8 yrs old

The size of the defibrillator paddles or self-adhering pads depends on the ___of the patient

age