Multiprofessional Critical Care Review: Pediatric 2024 (MCCRCP24ON)-Cardiopulmonary Resuscitation

Cardiopulmonary Resuscitation

Pdf Summary

The document is an educational presentation on cardiopulmonary resuscitation (CPR) for pediatric patients, authored by Dr. Ravi R. Thiagarajan and based on materials from Dr. Ryan W. Morgan. It covers epidemiology, protocols, and post-cardiac arrest care in pediatric populations.<br /><br />Key points include:<br />- **Epidemiology**: Out-of-hospital cardiac arrests (OHCA) occur in about 5000 cases per year, primarily among infants, often unwitnessed with non-shockable rhythms and a survival rate of 11.3%. In-hospital cardiac arrests (IHCA) have about 15,200 cases per year, commonly in ICUs, with a median patient age of 2 years and a 40-50% survival rate.<br />- **CPR Goals**: The primary goals of CPR are to provide temporary cardiac output, optimize conditions for Return of Spontaneous Circulation (ROSC), maximize coronary perfusion, and address reversible causes and underlying etiology with early defibrillation and high-quality chest compressions.<br />- **Pediatric Basic Life Support**: Recommendations include a compression-to-ventilation ratio of 30:2 for single rescuers and adolescents, and 15:2 for two rescuers and pre-pubescent children. Compression frequency is advised to be 100-120 compressions per minute, with specific depth recommendations based on patient size.<br />- **Pediatric Advanced Life Support (PALS)**: Guidelines suggest using advanced airways, appropriate medication dosages (e.g., epinephrine), and close monitoring of CPR quality through diastolic blood pressure and end-tidal CO2 levels.<br />- **Extracorporeal Life Support (ECLS)**: Can aid CPR (ECPR) by providing cardiac output and gas exchange, particularly recommended for pediatric patients with cardiac conditions within specialized settings.<br />- **Post-Cardiac Arrest Care**: Post-cardiac arrest care focuses on maintaining normotension, normothermia, normoxia, normocarbia, and normal glucose levels while treating seizures and using appropriate prognostic techniques.<br /><br />The summary emphasizes the importance of high-quality CPR, understanding PALS algorithms, and effective post-arrest care for improving outcomes in pediatric cardiac arrest scenarios.

Keywords

Pediatric CPR

Cardiac arrest

Epidemiology

CPR goals

Basic Life Support

Advanced Life Support

Extracorporeal Life Support

Post-cardiac arrest care

High-quality compressions

ROSC

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