Are there circumstances when resuscitation of the newly born infant may not be the appropriate action? Because all ED deliveries are considered “unexpected” and there is no previous relationship with the delivering mother, conversations about withholding resuscitation are difficult at best. Antenatal information can be incomplete or inaccurate. In the ED, it may not be …
Is induced hypothermia useful in treating children with cardiac arrest? There are no randomized studies on induced therapeutic hypothermia following cardiac arrest in pediatric patients. Therapeutic hypothermia (32° C to 34° C) may be beneficial for adolescents who remain comatose following resuscitation from sudden witnessed out-of-hospital VF cardiac arrest. Consider this for infants and children …
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Are AEDS useful for children with sudden collapse? Initially AEDs were not recommended for use in children under 8 years of age; however, newer models of AEDs have been shown to reliably recognize shockable rhythms in children. PALS guidelines as of 2010 now recommend use of AEDs for children 1 year of age and older. …
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What treatment is recommended for VF or pulseless ventricular tachycardia (VT) if electric shock is not effective? Amiodarone may be used for the treatment of shock-refractory or recurrent VF/pulseless VT in infants and children. If amiodarone is not available, consider the use of lidocaine. There are no pediatric data investigating the efficacy of lidocaine for …
How is defibrillation best accomplished? In any resuscitation, carefully check the rhythm after airway and breathing are established. Carefully confirm VF before defibrillation is attempted. Unmonitored defibrillation of a child is not recommended. Defibrillation works by producing a mass polarization of myocardial cells with the intent of stimulating the return of a spontaneous sinus rhythm. …
What role does defibrillation play in pediatric resuscitation? Historically, pediatric resuscitation has focused on pulmonary causes; defibrillation is a relatively uncommon intervention in pediatric resuscitation. Although asystole remains the most commonly observed arrhythmia during pediatric cardiac arrests, recent research indicates that VF may occur much more frequently than originally thought. The National Registry of Cardiopulmonary …
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Does calcium have any usefulness in pediatric resuscitations? The American Heart Association does not recommend the routine use of calcium in pediatric cardiac arrest. Although the use of calcium during resuscitation has declined considerably, there remain specific instances when it has significant value. Use calcium to remedy the following situations: • Documented hypocalcemia • Documented hyperkalemia • Documented …