Pediatric life support

First aid fundamentals (28th October 2010)

1st 2nd

part : education Department of anaesthesiology and inten. medicine, SNP 1 st. part :education Department of Traumatology, Rastislavova 43 st.

Seminary room KAIM 2nd floor, SNP st. 1, we ask students to wait for teacher on the 2nd floor in front of University Department of Anaesthesiology & Intensive Care Exercise date

Time

Seminary room KAIM

Lecture

PA 14.00 – 15.30h

3.11.2010 Wednesday

10.00-10.45h

DM 4ab

29.10.2010 Friday

KAIM

12.00- 12.45h

Substitute date

3.12.2010 Friday

TEST

14.00- 14.45 h

Substitute date

Substitute date is for students, who were not able to arrive for normal date. 3.12.2010 14.00h TEST: 10 MCQ First aid ( Basic life support adults, Pediatric basic life support, Shock, Wounds, Heat Stroke, Burns , Emergency Rescue and Transfer – Removal from Automobile,… Literature: First Aid Manual, Latest Update, St John Ambulance Association, 2005, www.erc.com, Moule P., Albarran J., 2009: Practical resuscitation for healthcare professionals www. books.google.com

Paediatric basic life support Monika Grochová MD, PhD Klinika anestéziológie a intenzívnej medicíny LF UPJŠ a UNLP Košice

• www.erc.edu

www.resus.org.uk

• Resuscitation (2005, 2010) 67 Supplement • Resuscitation (2005, 2010) 67

Basic life support

A B C

irway – airways opening

reathing – arteficial ventilation irculation – recovery of circulation CBA adults

Paediatric basic life support • simplification based on the knowledge that many children receive no resuscitation at all because rescuers fear doing harm Age:

- An infant is a child under 1 year of age - a child is between 1 year and puberty 25 kg, 8. years

CPR IN CHILDREN • Adult CPR techniques can be used on children • Compressions 1/3 of the depth of the chest

30 3 0

BASIC LIFE SUPPORT (BLS) Approach safely Check response Shout for help

Open airway

Campbell

head tilt and chin lift,

BASIC LIFE SUPPORT (BLS) Approach safely Check response Shout for help

Open airway Check breathing

Look, listen and feel for NORMAL breathing

Breathing • Take

a breath and cover the mouth and nasal apertures of the infant with your mouth, making sure you have a good seal • Blow steadily into the infant’s mouth and nose over 1—1.5 s, sufficient to make the chest visibly rise

• Take another breath and repeat this sequence five times

Breathing No effective breathing: - the airway may be obstructed • Open the child’s mouth and remove any visible obstruction. • Ensure that there is adequate head tilt and chin lift, try the jaw thrust method • Make up to five attempts to achieve effective breaths; if still unsuccessful, move on to chest compressions

Breathing, circulation • look for signs of a circulation any movement, coughing normal breathing=circulation is present (not agonal gasps, which are infrequent, irregular breaths)

Basic life support • Chest compressions – – – – – – – – –

To 1. year 2 fingers (2 thumbs circular) Over 1. yer one hand/two hands Low part of sternum Thumb over processus xiphoideus Compression by 1/3 of antero-posterior distance AED Children > 1 year Smaller size of pads for children to 8 years 50 – 75 J (4 J/kg)

Chest compression

Chest compressions •

to depress the sternum by approximately one third of the depth of the chest

•

and repeat at a rate of about 100 min−1

Chest compressions : breaths 30:2

AED IN CHILDREN • Age > 8 years • use adult AED • Age 1-8 years • use paediatric pads / settings if available (otherwise use adult mode)

• Age < 1 year • use only if manufacturer instructions indicate it is safe

AED DEFIBRILLATION

ATTACH PADS TO CASUALTY’S BARE CHEST

ANALYSING RHYTHM - DO NOT TOUCH VICTIM

SHOCK INDICATED

• Stand clear • Deliver shock

SHOCK DELIVERED FOLLOW AED INSTRUCTIONS

30

2

Recovery position

Approach safely

Approach safely

Check response

Check response

Shout for help

Shout for help

Open airway

Open airway

Check breathing

Check breathing

Call 112

Call 112

5 rescue breaths

Attach AED

30 chest cmpressions

Follow voice prompts

Anatomical diferencies of airwais by children

Postresuscitation care • Aproppriate tissue perfusion • Cooling – if unconsiousness after CPR – 32 – 34°C of body core 12 – 24 hours – Warming 0,25 – 0,5°C / hour – AE- infection, koagulopathy, glykémia, ións, circulation – Avoid hyperthermia - antipyretics

ETICS and CPR • Start – not start • Parents´presens during CPR • Decision to stp CPR- team leader, not parents

CPR of newborn

Newborn resuscitation • Lungs distension- ambu- bag with face mask, in term newborn f: 30-60/min if bradycardia persists - increase oxygen concentration • Mecónium – desuflation by weak newborns • Compressions- breathing ratio 3:1 90 compressionsií and 30 breaths • Adrenalín, if despite art. Vent.with O2 bradycardia 60/min • Circulation support evective only by lungs distension • Temperature of body core maintenance

Foreign body airway obstruction – Combination of methods needed – 5 hits back blows – 5 chest compressions (till 1year) / abdominal thrusts over 1 year – Horisontal rib´s position – abdominal organs damage risk

ANY QUESTIONS?