The physiology behind resuscitation guidelines

Abstract 

The guidelines for paediatric resuscitation have been made by international consensus, following a review of the available research data, but evidence is limited. In children, respiratory arrest usually precedes cardiac arrest, so there is an emphasis on respiratory support in this age group. In older children and adults, the underlying pathology may be different, and emergency medical service activation should immediately be sought. Pulse checks for lay rescuers have been omitted because of inherent difficulty for the inexperienced. The preferred method of cardiac compression in infants is with two apposed thumbs and hands encircling the chest. Two-finger compressions continue to be recommended for lay rescuers. Automated external defibrillators are not currently suitable for use in infants and young children, although manufacturers are developing such instruments. High-dose epinephrine is no longer routinely recommended in cardiac arrest as there are significant adverse effects. Amiodarone is used for the treatment of ventricular tachyarrhythmias in place of lignocaine.

Keywords: resuscitation, research, rescue breath, cardiac compression, defibrillation, epinephrine, amiodarone

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• f1 Correspondence to: EB. Tel. +61 8 8161 7000; E-mail: eileenbyrne8@ hotmail.com