cpr in pediatric practical practice.pptx

This ppt describes about the cpr in pediatric practice.

1. CARDIOPULMONARY RESUSCITATION (CPR) IN PEDIATRIC PRACTICE

2. WHY LEARN CPR ? When a person has a cardiac arrest, survival depends on immediately getting CPR from someone nearby. Almost 90 percent of people who die from cardiac arrest in the out-of-hospital setting. CPR, especially if performed in the first few minutes of cardiac arrest, can double or triple a person’s chance of survival.

3. LEADING CAUSES OF DEATH Congenital malformations Complications of prematurity SIDS Injury INFANTS CHILDREN

4. PEDIATRIC CARDIAC ARREST PBLS – Pediatric Basic Life Support PALS – Pediatric Advanced Life Support

5. PEDIATRIC CHAIN OF SURVIVAL

6. PEDIATRIC CHAIN OF SURVIVAL Prevention of cardiac arrest Perform early CPR Active Emergency response system Advanced life support Post resuscitation care PBLS PALS

7. PATHWAYS TO CARDIAC ARREST

8. RECOGNITION OF CARDIAC ARREST 1. Absence of signs of cardio respiratory function No movement No breathing or No response to rescue breaths No pulse 2. Arrest rhythm on the cardiac monitor (Note: Monitoring is not mandatory for recognition of cardiac arrest)

9. INITIATION OF CPR To decrease the time to initiation of chest compressions and reduce “no blood flow” time. Time to first ventilation is delayed by only approximately 6 seconds.

10. Provide CPR even when the unresponsive victim has occasional gasps. Conventional CPR (chest compressions and rescue breaths) should be provided for pediatric cardiac arrests. Compression-only CPR is effective in patients with a primary cardiac event, if rescuers are unwilling or unable to deliver breaths, AHA recommend rescuers perform compression-only CPR for infants and children in cardiac arrest.

11. PALS 2015

12. PALS 2015

13. REVERSIBLE CAUSES 6 H’s and 5 T’s

14. RESCUE BREATHING

15. BAG-MASK VENTILATION

16. CHEST COMPRESSIONS RATE: 100 to 120 / min DEPTH: (≥ 1/3 of anteroposterior diameter of chest) Infants – 1.5 inches (4 cm) Children – 2 inches (5 cm) Adolescents – at least 2 inches (5 cm) but not greater than 2.4 inches (6 cm).

17. Chest Compressions in Infant

18. Chest Compressions in Infant

19. Chest Compressions in Children

20. AUTOMATED EXTERNAL DEFIBRILLATOR (AED) < 8 yrs; < 25 kg AED with dose attenuator

21. MANUAL DEFIBRILLATOR The recommended first energy dose for defibrillation is 2 J/kg. If a second dose is required, it should be doubled to 4 J/kg. Subsequent doses 4 J/kg up to maximum of 10 J/kg.

22. Placement of pads or paddles Children (>1 yr; >10 kg – adult size) Right upper chest below the clavicle Lateral to the left nipple below the axilla Infants (<1 yr; <10kg – infant size) Sternum below the mammary line Back between two scapulae

23. EPINEPHRINE IO/IV dose: 0.01 mg/kg (0.1ml/kg), 1:10000 concentration Endotracheal dose: 0.1 mg/kg, 1:1000 concentration

24. IO/IV dose: 5 mg/kg bolus Repeat up to 2 times for refractory VF / Pulseless VT IO/IV dose: 1 mg/kg loading dose Maintenance: 20 – 50 mcg/kg/min infusion AMIODARONE LIDOCAINE

25. “HIGH QUALITY CPR” Push “Fast” (100 – 120 / min). Push “Hard” (≥ 1/3 of anteroposterior diameter of chest). Allow complete chest recoil. Minimize interruptions in chest compressions. Rotate compressor every 2 min or sooner if fatigued. If no advance airway, 30:2 compression-ventilation ratio (single rescuer); 15:2 compression-ventilation ratio (multiple rescuers). If advance airway, compression rate of 100 – 120 / min, 1 breath every 6 seconds (10 breaths/min). Avoid excessive ventilations.

26. MCQ’S

27. How many cycles of CPR are recommended in 2 min duration? A) 2 B) 3 C) 4 D) 5

28. What is the maximum depth of chest compressions in adolescents during CPR? A) 3 cm B) 4 cm C) 5 cm D) 6 cm

29. Which of the following arhythmia is referred to as “shockable rhythm”? A) Asystole B) Pulseless VT C) Pulseless electrical activity D) Bradyarhythmia

30. What is the ECG diagnosis? A) Supraventricular tachycardia B) Ventricular tachycardia C) Ventricular fibrillation D) Asystole

31. What is the first energy dose of defibrillation? A) 1 J/Kg B) 2 J/Kg C) 3 J/Kg D) 4 J/Kg

32. What is the dose of IV epinephrine in CPR? A) 0.1 mg/kg of 1:10000 B) 0.1 mg/kg of 1:1000 C) 0.01 mg/kg of 1:10000 D) 0.01 mg/kg of 1:1000