Paediatric Basic Life Support (BLS) Comprehensive Notes

Introduction to Paediatric Basic Life Support (BLS)

  • Paramedic Science Overview: Knowledge required for emergencies involving infants and children.
  • Instructor: Gary Smart, Senior Lecturer in Emergency and Critical Care, University of the West of England.

Cardiac Arrest in Children

  • Types of Cardiac Arrest:
    • Primary Cardiac Arrest: Infrequent in children, sudden onset, mainly due to arrhythmias. Initial hypoxia and acidosis may not be present, outcomes depend on early defibrillation.
    • Secondary Cardiac Arrest: More common in children, caused by hypoxia or ischaemia related to other conditions (like asphyxia), usually presents with bradycardia which progresses to asystole. Hypoxia is initially present, outcomes rely on rapid resuscitation.

Emergency Scenario Description

  • Case Study: A 2-year-old girl with urinary tract infection showing symptoms of back pain, drowsiness, confusion, and ultimately collapsing (pulseless, apnoeic).
  • Paramedic Actions: Immediate recognition and intervention required.

Assessment Techniques

  • Paediatric Assessment Triangle (PAT): Evaluate appearance, work of breathing, and circulation to skin.
    • Appearance: Moribund, floppy, or lifeless.
    • Breathing: Note any gasps or abnormal breathing patterns.
    • Circulation: Check for pallor, grey or cyanotic skin.

Resuscitation Guidelines

  • Initial Actions:
    • Ensure scene safety for both rescuers and victims.
    • Assess patient responsiveness (AVPU: Alert, Verbal, Pain, Unresponsive).
    • Open the airway and ensure breathing is adequate.
    • If not breathing normally, apply 5 rescue breaths followed by chest compressions (15:2 ratio).

Airway Management

  1. Infants (
  2. Older Children: Tilt the head back and lift chin while stabilizing the forehead.

Chest Compressions

  • For Children and Infants:
    • Technique: Place hands on the lower half of the sternum, ensuring full recoil after each compression.
    • Rate: 100-120 compressions per minute.
    • Depth:
    • Infants: At least 4 cm depth.
    • Children: At least 5 cm depth (one-third of chest depth).

Ventilation Strategies

  • Use bag-mask ventilation with 100% oxygen.
  • Each ventilation should take about 1 second, allowing adequate time for chest rise and fall.

Post-Defibrillation Action

  • After delivering a shock, immediately resume chest compressions for 2 minutes before reassessing.
  • Check for signs of life after CPR and continue as necessary.

Special Considerations

  • Ensure parents are present during resuscitation when possible to help ease anxiety and provide clarity on the actions being taken.

Equipment and Resources

  • Familiarize with Lifepak 15 monitors and defibrillators as well as other emergency medical kits for children.

References for Further Study

  • Include relevant guidelines and research articles that outline best practices and updated protocols in paediatric life support, including recent trends and studies.