Pediatric Basic Life Support (PBLS)

Part 11, IV-156 to IV-166

Highlights:

Lay rescuer should perform 2 minutes of CPR on unresponsive child prior to calling 9-1-1/get AED (Phone Fast).

Sudden, witnessed collapse: Healthcare Provider (HCP) should call 9-1-1/get AED prior to starting CPR (Phone First)

AEDs may be used on children 1-8 years old, preferably with dose-attenuating system.

Pediatric CPR:

Lone rescuer: If a child is unresponsive, perform CPR for 5 cycles at a compression-ventilation ratio of 30:2 (about 2 minutes) before activating EMS and retrieving AED, if available. (p. IV-157)

This can be modified for special situations such as a child with known heart rhythm problems or if a patient has their own device.

Lone HCP: "If the arrest is witnessed and sudden (e.g., an athlete who collapses on the playing field), activate EMS and get AED (if the child is 1 year of age or older) before starting CPR". This would also be ideal for the lone lay rescuer, but for simplicity of training, it is acceptable for this rescuer to provide CPR (as described above) before leaving to phone 9-1-1/retrieve AED. (p. IV-157)

"If two rescuers are present, one rescuer should begin CPR while the other rescuer activate EMS and get the AED." (p. IV-157)

Pediatric AED

"Since the publication of the ECC Guidelines 2000, data has shown that AEDs can be safely and effectively used on children 1 to 8 years of age." "However, there is insufficient data to make a recommendation for or against using an AED in infants less than 1 year of age (Class Indeterminate)." (p. IV-162)

Although there is no recommendation for use on infants, Infant/Child Reduced Energy Defibrillation Electrodes from Physio-Control are for use on children up to 8 years of age. For pediatric AED use, we have a published manuscript supporting the safety and efficacy of our attenuated adult biphasic shocks in an experimental model. To order a reprint of this article, click here. You will be routed to our request page; please type "Berg Study" in the message box that appears. [1]

"In systems and institutions that care for children and have an AED program, it is recommended that the AED have both a high specificity in recognizing pediatric shockable rhythms and a pediatric dose-attenuating system to reduce the dose delivered by the device. In an emergency if an AED with a pediatric dose-attenuating system is not available, use a standard AED." (p. IV-162)

Our AED algorithm is validated with pediatric heart rhythms. A published manuscript (Atkinson, et al) supports the efficacy of the Physio-Control Shock Advisory Algorithm in AED use on children under 8 years of age. To order a reprint of this article, click here. You will be routed to our request page; please type "Atkinson Study" in the message box that appears. [2]

Pediatric HCP BLS Algorithm, Step 9: Give 1 shock (for shockable rhythm) then resume CPR immediately for 5 cycles. (p. IV-158)

Unstacked shocks are recommended for all victims. Incorporation of cprMAX technology will allow for this functionality in our devices.