Paediatric Basic Life Support & First Aid

The purpose of this presentation is to introduce and refresh some basic life support principles for children.

Children are much more than ‘little adults’, and whilst the majority of first aid principles are similar, it’s important to bear to be aware of the differences.

This presentation is attended for lay-people and healthcare students. If you are a healthcare professional or wish to extend your knowledge, please read the Paediatric Advanced Life Support Edition.

If you’re unfamiliar with Adult First Aid or First Aid principles in general, please look at Basic Life Support & First Aid 2012 presentation first.

Check for

Check for

Check

Check for

Give

Apply a

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esponse

irways

reathing

PR

efribrillator

end for help

Check for Danger

To you

To others

To the Casualty

Make the area safer or remove yourself and casualty to an area of safety.

If an area is too dangerous stand back and call emergency services.

Check the Child for a response

Response may vary due to the age of the child.

Most basic method of assessment is the ‘Talk & Touch’ approach.

Can also use the COWS Method.

C an you hear me?

O pen your eyes.

W hat is your name?

S queeze my hand

Rubbing on the palms of the hands or soles of an infant’s feet may elicit a response.

Help can be anyone nearby, but you should aim to contact a healthcare professional or service as quickly as possible.

Call to reach emergency services virtually anywhere in

the world.

Someone should always stay with the child. Send others to get help.

Call for USA

or

for Australia

or

Notify your Cardiac Arrest Team within the hospital

In an unconscious casualty, the maintaining/gaining a patent airway is the top priority.

Check the airway is open and clear of obstructions.

In an unconscious patient, the tongue is the most common cause of obstruction.

Also check the airway for blood, vomit & any other foreign materials.

If the airway is blocked, the casualty can’t breathe.

Clearing the airway

Turn child on one side.

Clearing visible foreign material from mouth and nostrils.

If suction is available use suction to clear material.

Back Blows

Chest Thrust

Placing the child in the recovery position, if they are breathing, and post airway clearance can be useful.

Head tilt/Chin lift

Tilt head backwards (not neck)

Support jaw at the point of the chin

Jaw Thrust

Good if neck injury is suspected

Difficulty with obtaining adequate airway with Head tilt/chin lift.

Airway manoeuvres and appropriate positioning in children can differ from adults, dependant upon size.

Infants (<1yr) should have their head in the horizontal or neutral position.

Look, Listen & Feel

Up to 10 secs

Look for rise and fall of the chest

Listen for breath sounds or air arising from the nose or mouth

Feel for chest wall movement

If not breathing, and the casualty has a patent airway, rescue breathing should be commenced.

In clinical situations use a face mask to deliver breaths.

CPR = Compression + Ventilation

COMPRESSION RATE: 100 compressions/min

Useful tunes to keep the rate are ‘Staying Alive’ – Bee Gees, Another one bites the Dust and many more.

RATIO: 30 Compressions to 2 ventilations (breaths)

CYCLES: 5 cycles of [30:2] in approximately 2 minutes. Recheck for signs of life at the end of cycle.

Pause compressions to allow for ventilation.

Most important step is recognising need for CPR.

CPR should be commenced immediately in children if;

Unresponsive

Not breathing normally

Not moving, signs of life.

Lay rescuers should begin CPR, based upon the above information. Checking for a pulse is not required or recommended.

For HCPs, the Brachial or Femoral pulse are typically the easiest to assess. If pulse not identified within <10 seconds CPR should commence.

Ref: Pulse check versus check for signs of life Peds-002A

Kids will generally not tolerate CPR if they are conscious, so you might as well do it.

You do Chest Compressions in approximately the same place right through from infants to adults.

Compressions are done in the midline on the lower half of the sternum or the ‘centre of the chest’.

The nipples can be used as landmarks to guide you to where you should be doing your compressions.

Compressions should not be done over the lower end of the

sternum or abdomen

Push hard and fast, with straight arms.

Infants (<1yo)

Use 2 fingers over the centre of the chest.

Compress to 1/3 depth of chest wall (~4cm).

Child (1-8yrs)

Use heel of 1 hand, or alternatively 2 hands, with one positioned on top of the other.

Compress 1/3 depth of chest wall (~5cm) in the centre of the chest.

Greater than 8yrs = same as adult

Don’t stop CPR to check for a response or breathing – except at the end of a cycle.

Interruptions to CPR should be minimised.

If possible change the person giving compressions every 2 minutes.

CPR should continue until the casualty becomes responsive, or a healthcare professional arrives.

If a Debrillator (e.g. Automated External Defibrillator – AED) is available, apply and follow voice prompts.

CPR continues until the AED is present, all the pads are in place and the AED is on.

AEDs accurately identify heart rhythms as either ‘shockable’ or ‘non-shockable’.

Remember when shocking the casualty to get everyone to stand well back. Do not touch them!

AEDs can be used on children of any age.

However, for small children & infants, paediatric pads and an AED with a Paediatric functionality should be used if available.

Large children can use the normal adults pads & AED.

Pad Placement

Most pads have a diagram on them illustrating where to place them (e.g. right upper chest & left lower side).

Pads should never be touching each other.

In small children you can alternatively place one pad on the front of the chest, and one on the back.

Information

Australian Resuscitation Council

Resus4Kids

Photos

St John’s Ambulance

Global Medical Education Project

Pixar Wikia

Physio-Control, Inc.

Shaun Wood

Michael Kappel

Vicki’s Pics

US Army Africa

Wikimedia

Peter Daems

Whilst I am a medical professional the information provided here does not constitute medical advice. The information provided here is primarily based off the Australian Guidelines and my own experience in healthcare. Practice may differ in your area.

This presentation is not a substitute for professional training or appropriate medical advice. In fact if you have not done it, I hope this presentation inspires you to take a first aid course.

Please contact your local medical practitioner if you have any concerns.

Cheers,

Aaron

Paediatric Advanced Life Support

Extend your knowledge.

Learn advanced life support skills for the care of children.

Basic Life Support & First Aid 2012

Principles of Basic Life Support

Revisit DRSABCD

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