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Pediatric

Pediatric. قال تعالى (000ومن أحياها فكأنما أحيا الناس جميعا000). Cardiopulmonary resuscitation (CPR) : - It is an emergency procedures which is performed on person suffering cardiac or respiratory arrest.

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Pediatric

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  1. Pediatric

  2. قال تعالى (000ومن أحياها فكأنما أحيا الناس جميعا000)

  3. Cardiopulmonary resuscitation (CPR): - It is an emergency procedures which is performed on person suffering cardiac or respiratory arrest. -It is a combination of rescue breathing (mouth-to-mouth resuscitation) and chest compressions. CPR can restore circulation of oxygen-rich blood to the brain.

  4. -The commonest cause of cardiopulmonary arrest in pediatric is respiratory.

  5. Change in CPR Sequence: C-A-B Rather Than A-B-C

  6. 2010 (New): A change in the 2010 AHA Guidelines for CPR and ECC is to recommend the initiation of chest compressions before ventilations.2005 (Old): The sequence of adult CPR began with opening of the airway, checking for normal breathing, and then delivering 2 rescue breaths followed by cycles of 30 chest compressionsand 2 breaths.

  7. CPR 2010

  8. -Cardiopulmonary resuscitation (CPR) is a series of lifesavingactions that improve the chance of survival following cardiacarrest.

  9. The 2010 AHA Guidelinesfor CPR and ECC recommend CAB sequence. (chest compressions- airway- breathing)

  10. -Most cardiac arrests in adults are resulting from aprimary cardiac cause (e.g:VF) the chest compressions are more important than ventilations. - Cardiac arrest in childrenis most often asphyxial, which requires both ventilations andchest compressions for optimal results.

  11. -Starting CPR with 30 compressionsfollowed by 2 ventilations should theoretically delay ventilationsby only about 18 seconds for the lone rescuer and by an evena shorter interval for 2 rescuers. -The CAB sequence for infantsand children is recommended in order to simplify training withthe hope that more victims of sudden cardiac arrest will receivebystander CPR.

  12. Pediatric Chain of Survival 2010

  13. BLS Sequence for Lay Rescuers :- These guidelines delineate a series of skills as a sequenceof distinct steps depicted in the Pediatric BLS:- • Safety of Rescuer and Victim:- Always make sure that the area is safe for you and the victim.

  14. Assess Need for CPR:- To assess the need for CPR, the lay rescuer should assume thatcardiac arrest is present if the victim is unresponsive andnot breathing or only gasping.

  15. Check for Response:- - Gently tap the victim and ask loudly, If the child is responsive, heor she will answer or move. Quickly check to see if thechild has any injuries or needs medical assistance. - If you arealone and the child is breathing, leave the child to phone theemergency response system, but return quickly and recheck thechild's condition frequently. - Children with respiratory distressoften assume a position that maintains airway patency and optimizesventilation.

  16. Check for Breathing:- - If you see regular breathing, the victim does not need CPR. -If the victim is unresponsive and not breathing (or only gasping),begin CPR.

  17. Start Chest Compressions (C) :-During cardiac arrest, high-quality chest compressions generateblood flow to vital organs. -If the infant or child is unresponsive and not breathing, give30 chest compressions.

  18. -The following are characteristics of high-quality CPR:- • Chestcompressions of appropriate rate and depth. "Push fast":pushat a rate of at least 100 compressions per minute. "Pushhard":push with sufficient force to depress at least one thirdtheanterior-posterior (AP) diameter of the chest or approximately1 inches (4 cm) in infants and 2 inches (5 cm) in children. • Allow complete chest recoilafter each compression to allowthe heart to refill with blood. • Minimize interruptions of chest compressions.

  19. - For best results, chest compressions on a firm surface. -For an infant, lone rescuers, should compress the sternum with 2 fingers, placed just below the intermammary line. Do not compress over the xiphoid or ribs.

  20. Two-finger chest compression technique in infant (1 rescuer).

  21. Two thumb-encircling hands chest compression in infant (2 rescuers)‏

  22. - For a child, lay rescuers should compressthe lower half of the sternum at least one third of the AP dimensionof the chest or approximately 5 cm (2 inches) with the heelof 1 or 2 hands. Do not press on the xiphoid or the ribs. - After each compression, allow the chest to recoil completely. because complete chest re-expansion improvesthe flow of blood returning to the heart.

  23. Open the Airway and Give Ventilations(A –B):- -For the lone rescuer a compression-to-ventilation ratio of 30:2is recommended. After the initial set of 30 compressions, openthe airway and give 2 breaths. -In an unresponsive infant orchild, the tongue may obstruct the airway and interfere withventilations, open the airway using a head tilt–chinlift maneuver.

  24. - To give breaths to an infant, use a mouth to mouth and nosetechnique. - To give breaths to a child, use a mouth-to-mouthtechnique. Make sure the breaths are effective (i.e. the chestrises). Each breath should take about 1 second. If the chestdoes not rise, reposition the head, make a better seal andtry again.

  25. Coordinate Chest Compressions and Breathing:- -After giving 2 breaths, immediately give 30 compressions. Thelone rescuer should continue this cycle of 30 compressions and2 breaths for approximately 2 minutes beforeleaving the victim to activate the emergency response systemand obtain an automated external defibrillator (AED). -Ratio of compression : ventilation 30:2 for one rescue, and 15:2 for 2 rescue.

  26. Activate Emergency Response System:- -If there are 2 rescuers, one should start CPR immediately andthe other should activate the emergency response system and obtain an AED, if one is available. -Most infants and children with cardiac arrest have an asphyxialrather than a VF arrest; therefore 2 minutes of CPR arerecommended before the lone rescuer activates the emergencyresponse system. The lone rescuershould then return to the victim as soon as possible and usethe AED (if available) or resume CPR.

  27. BLS Sequence for Healthcare Providers: For the most part the sequence of BLS for healthcare providersis similar to that for laypeople (one rescue) with some variation as indicatedbelow. Healthcare providers are more likely towork in teams.

  28. Thank you

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