Flashcards in Cardiopulmonary Arrest ✅ Deck (55)
What is the incidence of cardiopulmonary arrest in children in developed countries?
1-20 per 100,000 children per year
In which children do the majority of cases of cardiopulmonary occur in?
Children under 1
How does the cause of cardiopulmonary arrest differ in children compared to adults?
In adults, it is often due to primary cardiac disease, which occurs with near-normal function of circulatory and respiratory system until moment of arrest. In children, most occur secondary to hypoxia due to respiratory failure or circulatory failure
What are the most common causes of circulatory failure leading to cardiopulmonary arrest in children?
Fluid loss or fluid maldistribution
What is the result of most cases of cardiopulmonary arrest in children being secondary to respiratory or circulatory failure?
End organ damage is often already present at the time of cardiac arrest, and is responsible for their prognosis
In what % of children is there a cardiac cause for cardiopulmonary arrest?
Give 3 cardiac causes of cardiopulmonary arrest?
- Congenital heart disease
What is the result of survival from complex congenital heart disease improving?
Cardiopulmonary arrest in children is becoming more common
What might unrecognised cardiomyopathy or channelopathies cause?
Sudden unexpected ventricular fibrillation or pulseless VT
What should be done following an unexpected cardiac arrest or VT/VF arrest?
Referral to paediatric cardiologist
Family should also be referred
Why is it important to make a referral to a paediatric cardiologist after unexpected or VT/VF arrest?
Identifiable cause may be found following detailed investigations, and treatment can be given
What might be included in investigations for unexpected or VT/VF arrest?
- Genetic studies
- Pharmacological provocation tests
Why should the family also be referred to a paediatric cardiologist in unexpected or VT/VF arrest?
They may also be at risk of sudden death
What is achieved in CPR?
Delaying cell damage and death in the heart and brain by facilitating partial flow of oxygenated bloods to these organs
What is the purpose of CPR?
To provide a window of opportunity to restore breathing and spontaneous blood circulation
What does CPR consist of?
Chest compressions and breaths
What is the ratio of chest compressions to breaths in children?
15:2 (except in newborns, when 3:1 ratio required)
What is the best compression rate for CPR?
100-120 per minute
What is the recommended depth of compression?
1/3 of depth of chest
Why is it important that there is minimal interruption of chest compressions?
As coronary perfusion pressure has been shown to be greater with prolonged continuous compressions
How do the outcomes from bystander CPR compare in children to adults?
In adults, improves survival even if compression only. In children, doesn't improve survival if compression only
Why doesn't compression only bystander CPR improve survival in children?
Most out-of-hospital cardiac arrests are hypoxic in origin, and so rescue ventilation is important
What is prolonged resuscitation generally associated with?
Bad neurological outcome
What has a recent study into prolonged CPR in adults shown?
Neurological outcome is not directly correlated to duration of CPR
What is the result of it being shown that neurological outcome is not directly correlated with duration of CPR in adults?
Resuscitation Council does not recommend a specific duration for CPR, and instead clinicians should determine duration on case-by-case basis
When might prolonged resuscitation be appropriate?
When there is potential for a reversible cause
Does prolonged resuscitation in children have the same outcomes as in adults?
No they are worse
What improves the outcomes of prolonged resuscitation in children?
- Profound hypothermia (<30C)
- Intermittent return of spontaneous circulation
When is survival rate with prolonged resuscitation in children?
After 20-30 minutes