Driving points not to be missed
Push hard (at least 1/3 of the child's anterior-posterior chest diameter, approximately 5 cm in a child under 8 years of age and approximately 4 cm in a newborn to 1 year of age). Push quickly, at least 100-120 times per minute for all ages.
Minimize interruptions to less than 10 seconds at any one time.
It allows for full chest recoil without “tilting” between compressions. Tilting mexico email list with as little as 2.5 kg of force can impede venous return, increase right atrial pressure, and decrease coronary perfusion pressure.
Do not overventilate: approximately 12/minute in children and approximately 20/minute for infants.
If it is a shockable rhythm, consider 2 J/kg in the anterior-apical pad position or in the anterior-posterior pad position. If the rhythm is VF/VT, deliver an AED shock even if pediatric attenuated pads are not available. Note that the LD100 for a shockable rhythm is actually no shock at all.
No ALS drug has been shown to improve survival to hospital discharge and beyond. Although epinephrine is recommended as the drug of choice, this has not been confirmed in RCT trials.
Therapeutic hypothermia after pediatric cardiac arrest is currently under study. There is equipoise for institution of cooling after cardiac arrest.
Drugs and dosage
As noted above, no ALS drug has been documented to improve survival to hospital discharge.
