Resuscitation Child

Question 1

What does CPR stand for

Answer 1

Cardiopulmonary Resuscitation

Question 2

The Resuscitation Council UK uses four different definitions for paediatrics.

What are they

Answer 2

Newborn:
* A child just after birth

Neonate
* A child in the first 28 days of life.

Infant
* This refers to a child under the age of 1 year old.

Child
* This refers to a child between 1 year and puberty.

Question 3

Procedure For Resuscitation

Answer 3

Unresponsive –>Shout for help–> Open airway–>

Not breathing properly–>5 rescue breaths

No signs of life–> 15 chest compressions –> 2 rescue breaths and 15 chest compressions –> Call resuscitation team

Have to do this for one min

Question 4

In the event of finding a collapsed child:

Answer 4

• Ensure your personal safety. Wear personal protective equipment, if necessary
• Your first impression is important. Look at the child in general to see if they ‘look unwell’
• If the child is responsive or showing signs of life, perform an ABCDE assessment. Ensure that appropriate help is on the way.
• If the child is unconscious, unresponsive and is not breathing normally (occasional gasps are not normal and are a sign of a cardiac arrest), commence the paediatric basic life support sequence

Question 5

ABCDE Assessment

Answer 5

A=Airway
B=breathing
C=circulation
D=disability
E=Exposure

Question 6

ABCDE Assessment

Airway

Answer 6

A=Airway
Assessment you do:
Is the airway patent and maintained?
Can the patient speak?
Are there added noises?
Is there a see-saw movement of the chest and abdomen?

Can manage this by :
Ensure airway is patent and maintained
Simple airway manoeuvres such as head tilt, chin lift
Consider suction, airway adjuncts, position of the patient
Oxygen via non-rebreather mask

Question 7

ABCDE Assessment

Breathing

Answer 7

Observe:

Rate and pattern
Depth of respiration
Symmetry of chest movement
Use of accessory muscles
Colour of patient
Oxygen saturation

Management

Position of patient
Consider physiotherapy and nebulisers
Oxygen via non-rebreather mask
Bag valve mask ventilation

Question 8

ABCDE Assessment

Circulation

Answer 8

Assessment

Pulse
Capillary refill time
Urine output
Fluid balance
Temperature
Management

Have equipment prepared to obtain access (IV or IO)
When more advanced help arrives, take bloods and administer fluids if and when appropriate

Question 9

ABDC Assessment

Disability

Answer 9

Assessment

Conscious level using AVPU
Blood glucose level
Pain
Pupil size and reaction
Observe for signs of seizures

Management
Consider recovery position
Correct blood glucose
Control seizures
Control pain

Question 10

ABCDE Assessment

Exposure

Answer 10

Assessment

Perform head-to-toe examination, front and back
Look for signs of a rash or signs of injury/bleeding

Management
Manage abnormal findings appropriately

Question 11

How to resuscitate an Infant

Answer 11

1. When resuscitating an infant the initial approach remains the same as when resuscitating a child. You must always check for hazards, gently try to stimulate the child and, if there is no response, call for help early.
2. Open the airway. The infant’s head should be in a neutral position.Check the airway for any obstructions.
3. Check breathing. Look for chest movement
   Listen for breath sounds
   Feel for breath on your cheek
   For a maximum of 10 seconds. If in doubt, assume they are not breathing.
4. Five rescue breaths. Give five rescue breaths to make sure that the chest rises and falls with each breath. Reassess signs of life and commence chest compressions.
5. Chest compressions
   Locate the lower half of the sternum. If you are on your own, use two fingers. If there are others, use the encircling technique
   Depress the lower sternum by at least 1/3 the depth of the chest - 4 cm for an infant
   Release the pressure completely, then repeat at a rate of 100-120/min
   After 15 compressions, give two rescue breaths

Question 12

Encircling technique

Answer 12

Place both thumbs flat, side by side on the lower half of the sternum with the tips pointing towards the infant’s head
Spread the rest of both hands, with the fingers together, to encircle the lower part of the infant’s rib cage with the tips of the fingers supporting the infant’s back

Question 13

Choking in infants - Back blows

Answer 13

Back blows

Use gravity to help you
Using the heel of your hand between the shoulder blades, deliver up to five back blows
If the obstruction comes out at any stage, reassess the infant’s airway and breathing
If they are still choking after five back blows, move on to chest thrusts

Question 14

Choking in infants- Chest thrusts

Answer 14

Chest thrusts are to be used in children under 1 year of age
Use gravity to help you
Deliver up to five chest thrusts by placing two fingers in the centre of the chest and use a short, sharp inward and upward motion to try and remove the obstruction
If they are still choking, alternate between five back blows and five chest thrusts
If the child becomes unresponsive at any point, start CPR.

Question 15

Choking in a Child- Back Blows

Answer 15

If they will let you, lean the child forwards and stand or kneel behind them
Using the heel of your hands between the shoulder blades, deliver up to five back blows
If the obstruction comes out at any stage, reassess the child’s airway and breathing
If they are still choking after five back blows, move on to abdominal thrusts

Question 16

Choking in a Child- Abdominal Thrusts

Answer 16

Abdominal thrusts

Abdominal thrusts should only be used in children over 1 year of age
Give the child five abdominal thrusts - stand behind the child, hold a fist against the abdomen and press sharply inwards and upwards
If the obstruction comes out at any stage, reassess the child’s airway and breathing
If they are still choking, alternate between five back blows and five abdominal thrusts until the obstruction comes out

If the child becomes unresponsive at any point, start CPR.