CPR2015 update: Pediatric Basic Life Support

1. Pediatric BLS

2. Purposees of guidelines
• Infant BLS : < 1 years
• Child BLS : > 1 years – puberty (breast develop
in female , axillary in male)
• Adult BLS : > puberty

3. Topic reviewed in 2015
• C-A-B sequence
• New algorithms for 1 rescuer and multiple
rescuer pediatric HCP
• Upper limit 6 cm for chest compression depth
• Chest compression rate 100 – 120 /min
• Confirm compression and ventilation are
needed for pediatric BLS

4. High-quality CPR
• Ensuring chest compressions of adequate rate
• Ensuring chest compressions of adequate
depth
• Allowing full chest recoil between
compression
• Minimizing interruptions in chest compression
• Avoid excessive ventilation

5. BLS sequence for lay rescuer
• Safety of rescuer and victim
• Assess need for CPR
• Check for response : gently tap victim and ask loundly
• Check for breathing
– Regular breathing -> recovery position
– Not breath/grasping -> start CPR
• Start chest compression
• Open the airway and give ventilations
– Head tilt –chin lift maneuver in injured/non-injured victim
– Mouth to mouth and nose ->mouth to mouth -> mouth to nose
• Coordinate chest compression and breathing
– Chest compression 30:2 breath
• Activated emergency response system
– 2 resucer : 1 CPR , 1 activated emergency response system
– 1 rescuer : CPR first -> activated emergency response system

7. BLS sequence for HCP
• Assess the need for CPR
• Pulse check (10 sec)
• Inadequate breathing with pulse -> give rescue
breaths at rate 12 – 20 breaths/min (3-5
sec/breath) + reassure pulse every 2 min
• Bradycardia with poor perfusion
– HR < 60 bpm -> start CPR
• Chest compression
– 1 rescuer : 2 finger chest compression
– 2 rescuer : 2 thumb

10. • Ventilation
– head tilt –chin life
– Spine injury -> jaw thrust
• Co-ordinate chest compression and ventilation
(minimal interruptions)
– Non-advanced airway
• 1 rescuer -> 30 : 2
• 2 rescuer -> 15 :2
– Advanced airway :
• Chest compression : 100 – 120 compression / 2 min
• Ventilation : 8 – 10 breath / min = 6-8 sec/breath
BLS sequence for HCP

11. • Defibrillation : VF/pulseless VT ->manual defibrillation 2
J/kg -> 4 J/kg
• Defibrillation sequence using an AED
• Breathing adjunts
– Barrier devices
– Bag-mask ventilation(HCP)
– Precaution : avoid excessive ventilation
– 2-person Bag-mask ventilation
– Gastric inflation and cricoid pressure
– Oxygen : minimal FiO2 to keep O2sat 94%
– O2 mask : non rebreathing mask with oxygen inflow 15 L/min
– Nasal cannular : suitable for child with spontaneous breathing
BLS sequence for HCP

12. • Foreign-body airway bstruction
– Most common cause
• Infants : liquid
• Children : ballon , small objects and food
– S&S : sudden onset of respiratory distress with
coughing , gagging , stridor or wheezing
– Relief of FBAO
• Infant : 5 back blow , 5 chest thrust
• Child : Heimlich maneuver
BLS sequence for HCP

13. • Trauma
– Anticipate airway obstruction
– Stop all external bleeding with direct pressure
– Suspect spine injury -> minimize motion of the
cervical spine and movement of the head and
neck
BLS sequence for HCP

14. BLS – single
rescuer

15. Multiple
rescuer