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Basic Life Support

DAN Paediatric

Module

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• Paediatric Resuscitation – Child

• Paediatric Resuscitation – Infant

• Foreign Body Airway Obstruction (Child – Infant)

Paediatric Module

PAEDIATRIC MODULE Objectives

Child Resuscitation

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Ensure the safety of rescuer and child

Responsiveness?

If responsive

• Leave the child in the position you find him/her

• Check his condition and get help if needed

• Re-assess the child regularly

Unresponsive

• Shout for help

• Turn the child on his/her back

Child Resuscitation

CHILD RESUSCITATION Paediatric BLS – Sequence (lay rescuer)

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Look, listen and feel for no more than 10 seconds

• Open Airway

• head tilt and chin lift

• quick look into the mouth for foreign body objects

If the child is breathing normally

• Recovery position

• Send or go for help

• Check for continued normal breathing

Child Resuscitation


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If the breathing is not normal or absent

• Give 5 rescue breaths

• Pinch the soft part of the nose

• Allow the mouth to open, maintain chin lift

• Cover mouth with your mouth and make sure you have a good seal

• Blow steadily over 1-1,5sec, sufficient to make the chest visibly rise

• Maintain head tilt and chin lift, take your mouth away and watch the chest to fall

• Assess the child’s circulation (Look for signs of life within 10 seconds)

Child Resuscitation


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If there are no signs of life:

Start chest compressions

• 30 chest compression

• Compress the lower half of the sternum

• Depress the sternum at least 1/3 of the depth of the chest

• approximately 5 cm in children

• Release the pressure completely and repeat

• At least 100 compression/min (not exceeding 120)

Combine 2 rescue breathing and chest compressions

• 30:2 sequence for lay rescuer

Child Resuscitation


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• Place heel of the hand on the lower part of the sternum

• Lift fingers

• Make sure pressure is not applied over the the ribs

• Position yourself above the child’s chest

• Arm straight

• Maintain head tilt with the other hand

Child Resuscitation

CHILD RESUSCITATION Chest Compressions : 1- Hand Technique

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Do not interrupt resuscitation until

• The child shows signs of life

• Starts to wake up, to move, opens eyes and to breath normally

• Qualified help arrives and takes over

• You become exhausted

Child Resuscitation


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When to call for help • When more than one rescuer is available

• One starts resuscitation, the other calls for help

• Only one rescuer

• Start CPR for 1 minute

• Call for help

• To minimise interruption in CPR, it may be possible to carry a small child with you whilst summoning help

• Immediately call for help in case of a witnessed, sudden collapse

• Probably will need defibrillation

Child Resuscitation


Skill Development

Session

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• Ensure your safety and the safety of the child • Unresponsive?

• Shout for help • Open airway

• Breathing is not normal or absent? • 5 rescue breaths • Look for signs of life • Start CPR

• 30 compressions / 2 rescue breaths • Continue CPR until signs of life:

• starts to wake up, to move, opens eyes and to breath normally When alone go and call for help after 1 minute CPR

Skill Development Session

SKILL DEVELOPMENT SESSION Child BLS – Lay Rescuer

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Paediatric BLS PAEDIATRIC BLS BLS – Sequence - Overview

Unresponsive?

Not breathing normally?

Shout for help Open Airway

No signs of life?

5 rescue breaths

Call EMS after 1 minute CPR

2 rescue breaths 30 chest compressions

30 chest compressions

Infant Resuscitation

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Ensure the safety of rescuer and child Responsiveness?

• Gently stimulate the infant, tap or rub the sole of the infant’s foot and call his/her name to see if he/she responds. Never shake an infant

If responsive

• Leave the child in the position you found him/her • Check his condition and get help if needed • Re-assess him/her regularly Unresponsive • Shout for help • Turn the child on his/her back


INFANT RESUSCITATION Paediatric BLS – Sequence (lay rescuer)

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Breathing normally?

• Open Airway

• Ensure neutral position of the head and chin lift

• Check the mouth for foreign body objects in the mouth

Breathing normally

• Recovery position

• Cradle the infant in your arms, against your body, with his/her head tilted little downwards. This prevents him/her from chocking on his/her tongue or inhaling vomit.

• Send or go for help

• Check for continued normal breathing



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If the breathing is not normal or absent

• Give 5 rescue breaths

• Cover mouth and nose with your mouth and make sure you have a good seal

• Blow steadily over 1-1,5sec, sufficient to make the chest visibly rise

• Maintain head position and chin lift, take your mouth away and watch the chest to fall

• When using a oronasal resuscitation mask, ensure that the small part of the mask points toward the infant’s body

• Assess the infant’s circulation (Look for signs of life within 10 seconds)



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If there are no signs of life:

Start chest compressions

• 30 chest compression

• Compress the lower half of the sternum

• Depress the sternum at least 1/3 of the depth of the chest

• approximately 4 cm in infants

• Release the pressure completely and repeat

• At least 100 compression/min (not exceeding 120)

Combine 2 rescue breathing and chest compressions

• 30:2 sequence for lay rescuer



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• Place the infant on hard surface or position on lower arm and support the head with your hand

• Position 3 fingers on lower part of the sternum

• Top finger (closest to the head) on the imaginary line between the infant’s nipples

• Elevate top finger

• 2 fingers on the sternum

• Compress the sternum with 2 fingers


INFANT RESUSCITATION Chest Compressions : 2 - Finger Technique

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• At least two rescuers

• Place both thumbs, side by side on the lower part of the sternum

• Fingertips pointing towards the head

• Hands with fingers together on lower part of the rib cage

• Fingertips supporting the back


INFANT RESUSCITATION Chest Compressions : Encircling Technique

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Do not interrupt resuscitation until

• The infant shows signs of life

• Starts to wake up, to move, opens eyes and to breath normally

• Qualified help arrives and takes over

• You become exhausted



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When to call for help

• When more than one rescuer is available

• One starts resuscitation, one call for help

• Only one rescuer

• Start CPR for 1 minute

• Call for help

• To minimise interruption in CPR, it may be possible to carry an infant with you whilst summoning help



Skill Development

Session

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• Ensure your safety and the safety of the child • Unresponsive?

• Shout for help • Open airway

• Breathing is not normal or absent? • 5 rescue breaths • Look for signs of life • Start CPR

• 30 compressions / 2 rescue breaths • Continue CPR until signs of life:

• starts to wake up, to move, opens eyes and to breath normally When alone go and call for help after 1 minute CPR


SKILL DEVELOPMENT SESSION Infant BLS – Sequence (lay rescuer)

Foreign Body Airway

Obstruction

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Assess severity

• Effective cough

• Crying or verbal response to questions, loud cough, able to take a breath before coughing, fully responsive

• Encourage to cough

• Continue to check for deterioration of an ineffective cough or until obstruction is relieved

Foreign Body Airway Obstruction

FOREIGN BODY AIRWAY OBSTRUCTION Paediatric Treatment

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Ineffective cough

• Conscious

• Unable to vocalise, quiet or silent cough, unable to breath, cyonosis, decreasing level of consciousness

• 5 back blows

• 5 thrusts

• Infant: chest

• Child over 1 year: abdominal

Ineffective cough

• Unconscious

• Open airway

• 5 rescue breaths

• Start CPR


FOREIGN BODY AIRWAY OBSTRUCTION Paediatric Treatment

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• Back blows are more effective if the head is positioned down

• A small child can be placed across the lap

• Support the child in a forward leaning position

• Deliver back blows from behind

• Sharp back blow with the heel of one hand in the middle of the back, between the shoulder blades

• Try to relieve the obstruction with each blow, rather then to give all back blows


FOREIGN BODY AIRWAY OBSTRUCTION Back Blows – Child over 1 year

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• Kneel behind the child

• Place your arms under the child’s arms and encircle the torso

• Place your fist between the navel and the bottom of his/her breastbone

• Grasp the fist with your other hand

• Pull sharply inwards and upwards

Do not apply pressure on the xiphoid process or lower rib cage


FOREIGN BODY AIRWAY OBSTRUCTION Abdominal Thrust for Child over 1 year

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• Support in a head downward, prone position

• A seated or kneeling rescuer can support the infant across the lap

• Support the head

• Thumb at the angle of the lower jaw, two fingers on the otherside of the jaw

• Do not compress the soft tissues under the jaw

• Sharp back blow with the heel of one hand in the middle of the back, between the shoulder blades

• Try to relieve the obstruction with each blow, rather then to give all back blows


FOREIGN BODY AIRWAY OBSTRUCTION Back Blows - Infant

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• Head downward supine position

• Place an arm along the infant’s back and encircle the occiput with the hand

• Support the infant down on your arm, which is placed down on your thigh

• Identify the landmark for chest compressions (on the lower half of the sternum)

• Give chest thrust

• Similar to chest compressions, but sharper and delivered at a slower rate


FOREIGN BODY AIRWAY OBSTRUCTION Chest Thrust for Infants

Do not use abdominal thrust (Heimlich manoeuvre) for infants

Skill Development

Session

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• Mild airway obstruction


• Severe airway obstruction

• Conscious

• Up to 5 back blows

• If back blows fail, give up to 5 thrusts

• Child: abdominal

• Unconscious


• Start CPR


SKILL DEVELOPMENT SESSION Foreign Body Airway Obstruction - Child

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• Mild airway obstruction


• Severe airway obstruction

• Conscious

• Up to 5 back blows

• If back blows fail, give up to 5 thrusts

• Infant: chest

• Unconscious


• Start CPR


SKILL DEVELOPMENT SESSION Foreign Body Airway Obstruction - Infant

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Paediatric BLS PAEDIATRIC BLS Foreign Body Airway Obstruction - Overview

Ineffective cough

Effective cough

Unconscious Open Airway

5 rescue breaths Start CPR

Conscious 5 back blows

5 thrusts (chest for Infant)

(abdominal for child > 1 year)

Assess severity

Encourage cough Continue to check for

deterioration to ineffective cough or until obstruction is

relieved

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• Paediatric Resuscitation Techniques

• Paediatric BLS Sequence – Lay Rescuer

• Foreign Body Airway Obstruction

Basic Life Support Paediatric Module

BASIC LIFE SUPPORT - PAEDIATRIC MODULE Summary

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