tailieunhanh - Ebook ABC of resuscitation (5/E): Part 2

(BQ) Part 2 book “ABC of resuscitation” has contents: Resuscitation in hospital, resuscitation in the ambulance service, cardiopulmonary resuscitation in primary care, near drowning, cardiac pacing and implantable cardioverter defibrillators, teaching resuscitation, training manikins, and other contents. | 10 Resuscitation of infants and children David A Zideman, Kenneth Spearpoint The aetiology of cardiac arrest in infants and children is different from that in adults. Infants and children rarely have primary cardiac events. In infants the commonest cause of death is sudden infant death syndrome, and in children aged between 1 and 14 years trauma is the major cause of death. In these age groups a primary problem is found with the airway. The resulting difficulties in breathing and the associated hypoxia rapidly cause severe bradycardia or asystole. The poor long-term outcome from many cardiac arrests in childhood is related to the severity of cellular anoxia that has to occur before the child’s previously healthy heart succumbs. Organs sensitive to anoxia, such as the brain and kidney, may be severely damaged before the heart stops. In such cases cardiopulmonary resuscitation (CPR) may restore cardiac output but the child will still die from multisystem failure in the ensuing days, or the child may survive with serious neurological or systemic organ damage. Therefore, the early recognition of the potential for cardiac arrest, the prevention and limitation of serious injury, and earlier recognition of severe illness is clearly a more effective approach in children. Definitions ● ● ● An infant is a child under one year of age A child is aged between one and eight years Children over the age of eight years should be treated as adults Stimulate and check responsiveness Open airway. Head tilt, chin lift (jaw thrust) Yes Check breathing. Look, listen, feel If breathing, place in recovery position No Breathe. Two effective breathes Paediatric basic life support Early diagnosis and aggressive treatment of respiratory or cardiac insufficiency, aimed at avoiding cardiac arrest, are the keys to improving survival without neurological deficit in seriously ill children. Establishment of a clear airway and oxygenation are the most important actions in .