Ebook ABC of resuscitation (5/E): Part 2
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Ebook ABC of resuscitation (5/E): Part 2
10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2lh.il ill adults. Infants and childleu lately have primary cardiac events. In infants the commonest cause of death is sudden infant death syndrome, and in I hildreti aged between I and 14 years trauma is the major cause of death. In these age gloups a primary problem is found with the airway, lhe re Ebook ABC of resuscitation (5/E): Part 2sulting difficulties in breathing and the associated hyfxixia rapidly cause severe bradyimdia or asystole. The pool long-term outcome from many cardiaEbook ABC of resuscitation (5/E): Part 2
c arrests in childhood is related Io the severity of cellular anoxia that has Io occur before the child's previously healthy heart succumbs. Organs se10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2 restore caniiac output but the child will still die from multisystem failure in the ensiling days, or the chilli may survive with serious lie urological I or systemic organ damage. Therefore, the early recognition of the potential tor cardiac arrest, the prevention and limitation of serious injury, Ebook ABC of resuscitation (5/E): Part 2 and earlier recognition of severe dlnexs is clearly a more effective approach in children.Paediatric basic life supportEarly diagnosis and aggressiveEbook ABC of resuscitation (5/E): Part 2
treatment of respiratory or cardiac insufficiency, aimed at avoiding cardiac arrest, arc the keys to improving survival without nemological deficit i10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2rc prerequisites for other forms of treatment.Resuscitation should begin immediately without waiting for the arrival of equipment. This is essential in infants and children because clearing the airway may be all that is required. Assessment and treatment should proceed simultaneously Io avoid losing Ebook ABC of resuscitation (5/E): Part 2 vital time. As in any resuscitation event, the Airway Breathing Circulation sequence is the most appropriate.It aspiration of a foreign body is stronEbook ABC of resuscitation (5/E): Part 2
gly suspected, because of sudden onset of severe olislrmiion of the up|M*r airway, the steps outlined in the section on choking should be taken immedi10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2only if he or she is in a dangerous location.AirwayOpen the airway by tilting the head and lif ting the lower jaw. Care must lx- taken not to overextend the neck (as this may cause the soft trachea to kink and obstruct) and not to press on the soft tissues in the floor of the mouth. Pressure in this Ebook ABC of resuscitation (5/E): Part 2 area will force the tongue into the airway and cause obstruction. The small infant is an obligatory nose breather so the patency of the nasal passageEbook ABC of resuscitation (5/E): Part 2
s must be checked and maintained. Alternatively, the jaw thrust manoeuvre can be used when aDefinitions•Au infant is a chilli imdei one year of age•A 10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2----~---------------------Contnuí resusotỉBonAlgorithm fol poediauk baric life suppul IOpening infant airway43ABC. of Resuscitationhistory of trauma or damage to the cervical spine is suspected. Maintaining the paediatric airway is a matter oi' trying various positions until the most satisfactory on Ebook ABC of resuscitation (5/E): Part 2e is found. Rescuers must be flexible and willing to adapt their techniques.BreathingAssess breathing for 10 seconds while keeping the airway open by:Ebook ABC of resuscitation (5/E): Part 2
. I axiking for chest and abdominal movement . Listening at the mouth and nose for breath sounds . Feeling for expired air movement with your cheek.i10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2a foreign hixly. If the child is not breathing, expired air resuscitation must be started immediately. With the airway held open, die rescuer covers the child's mouth (or mouth and nose for an infant) with their mouth and breathes out gently into the chilli until the chest is seen to rise. Minimise Ebook ABC of resuscitation (5/E): Part 2gastric distension by optimising the alignment of the airway and giving slow and steady inflations. Give two effective breaths, each lasting about 1-1Ebook ABC of resuscitation (5/E): Part 2
.5 seconds, and note any signs of a response (the child may cough or “gag"). Up to five attempts may be made to achieve two effective breaths when the10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2lation is present. Iherefore. the rescuer should observe the child tor 10 seconds for “signs of a liriiilalioii.* Tins includes any movement, coughing, or breathing (more than an odd occasional gasp). In addition. heallhiỊire providetx are rx|x-i led Io cheek for the presence, rate, and volume of th Ebook ABC of resuscitation (5/E): Part 2e pulse. The brachial pulse is easiest IO feel in infants, whereas for children use the carotid pulse. Ihe femoral pulse is an alternative for either.Ebook ABC of resuscitation (5/E): Part 2
If none of the sigils of a circulation have lieen delected, then start chest compressions without further delay and combine with ventilation. Immedia10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2.In infants and children the heart lies under the lower third of the slerntim. Ill infants, coinpre.ss the lower lliiivl of the Sternum with two fingers of one hand: the upper finger should lie one ringer’s biradtb below an imaginary line joining the nipples. \\ hen more than one healthcare provider Ebook ABC of resuscitation (5/E): Part 2 is present, the iwo-lliiiuibed (chest encirclement) method of 11 lest compression can be used for infants. 1'hc thumbs arc aligned one finger's breadEbook ABC of resuscitation (5/E): Part 2
th lielow an imaginary line joining the nipples, the fingers encircle the chest, and the hands and fingers siip|xu I the infant's lib cage anil bai k.10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2en the sternum is compressed Io alxitil one third of the resting chest diameter: the rate is 100 comprcssions/min. The ratio of compressions Io ventilations should lx- 5:1. irrespective ol the number of rescuers, The compression phase should occupy half of the cycle and should lx- srmxith. not jerky Ebook ABC of resuscitation (5/E): Part 2.In larger, older children (over the age of eight years) the adult two-handed method of chest compression is normally used (sec Chapter I). The compreEbook ABC of resuscitation (5/E): Part 2
ssion rate is 100/min and the compression to ventilation ratio is 15:2, but the compression depth changes to 4-5 cm.Activation of the emergency medica10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l Ebook ABC of resuscitation (5/E): Part 2nd now vcmilaiionCIwm mtiipccwiori ill iritanb and chiklten44Resuscitatk... ~.._..........because the provision of advanced life support procedures is vital to the child's survival. The single rescuer may be able IO carry an infant or small child to the telephone, but older children will have to lie Ebook ABC of resuscitation (5/E): Part 2 left. Basic life support must lx- restarted as soon as possible alter telephoning and continued without further interruption until advanced life suppEbook ABC of resuscitation (5/E): Part 2
ort arrives. In circumstances in which additional help is available or the child has known heart disease, then the emergency medical services should b10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from l10 Resuscitation of infants and childrenDavid A Zideman, Kenneth Spearpointlhe aetiology of cardiac arrest in infants and children is different from lGọi ngay
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