Pediatric Basic Life Support

PBLS

Nanees Salem
Professor of Pediatrics
Objectives

 What is cardiopulmonary arrest.

 Basic life support vs. Advanced life support.

 Basic life support.

 Home message.

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What is cardiopulmonary
arrest??
 Cardiopulmonary arrest

 Primary Cardiopulmonary arrests, caused by arrhythmias

 Secondary Cardiopulmonary Arrests caused by either:

» Circulatory failure

» Respiratory failure

In children, Secondary Cardiopulmonary Arrests are more frequent

than primary arrests.

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 Cardiopulmonary arrest

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 Basic life support
vs.
Advanced life support.
 Basic life support vs. Advanced life support

Basic Life Advanced Life

Support Support
Place

Personnel

Equipments

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 Pediatric Life Support
Basic Life Support:
Resuscitation without using any equipment /out hospital

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 Pediatric Life Support
Advanced Life Support:
Resuscitation using equipment / At the hospital / Medical
Personnel

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Pediatric Basic Life Support
 Pediatric Basic Life Support

Definitions ( ONLY for life support)

 An infant is a child under 1 year of age

 Small child is between 1 year and 8 years

 Large child is a child above 8 years

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 BLS Sequence for Infants & Children

1.Safe Approach: ensure Safety of rescuer &

Child

2. Check the child ’s Responsiveness

3. Check ABC

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1- Ensure Safety of rescuer and Child
SAFE Approach
S Shout for help
A Approach with Care
F Free from danger
E Evaluate

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2- Check the child ’s Responsiveness

Gently Stimulate/Shake the child (not if suspected

cervical spine injury)

Ask child loudly “Are you all right”??

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Responsiveness ?

Are you all right ?

Open eyes
Cries
NO
Moves

ABC
Airway patency
Level of consciousness Recovery Position
Laryngeal function
2- Check the child ’s Responsiveness
 If responsive
Turn the child on his side
Recovery Position

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 Recovery Position

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2- Check the child ’s Responsiveness

 If NOT responsive
Evaluate The ABC

A irway

B reathing

Circulation
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 PBLS sequences

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 Anatomical factors in infants/children Airway

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 AIRWAY MANAGEMENT
Airway
Head-tilt/chin-lift method
Avoid extreme hyperextension

Jaw thrust method

With possible neck injury,

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 AIRWAY MANAGEMENT

head tilt chin lift method

Campbell
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 Breathing MANAGEMENT

Look, listen & feel for NORMAL breathing

for up to 10 seconds

 Look:
Chest movements.

 Listen:
Breath sounds.

 Feel:
Exhaled breath.

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Look, Listen, Feel …

Breathing well

Yes NO

Recovery
Position Rescue Breath
 Breathing MANAGEMENT

 If breathing normally
Turn the child on his side {Recovery Position}

Send/go for help * check for continued breathing

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 Breathing MANAGEMENT

 If NO breathing or Gasping
Rescue breath that makes the chest rise & fall
5 rescue breaths to achieve 2 effective ones

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 Breathing MANAGEMENT

Take a normal breath then cover the infant’s mouth &

nasal apertures with your mouth (be sure for good seal)

Blow steadily into the infant’s

mouth & nose over 1—1.5 sec
sufficient to make the chest
visibly rise

Take another breath & repeat

this sequence five times

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 Breathing MANAGEMENT

IF No effective breathing airway may be obstructed

• Recheck the child’s mouth &
remove any visible obstruction.
• Reposition the airway
head tilt and chin lift,
try jaw thrust method
• give 5 effective breaths
• If still unsuccessful
Check Circulation
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 PBLS sequences

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 Circulation MANAGEMENT

Feel / Check the pulse

In infant
brachial pulse at inner
aspect of upper arm
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Circulation
Pulse
Signs of life

Yes NO

Reassess Combine
Breathing Rescue
breathing
Recovery Position & chest
compression
 Circulation MANAGEMENT

If NO signs of a circulation
If you are not sure
If pulse < 60/min
Sings of poor perfusion (unresponsive/immobile)

Start Chest compression

Combine Rescue breathing & chest compression

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 Circulation MANAGEMENT

Chest compression
in Infant (1 year)
Land mark:
One finger breadth below line joining 2 nipples

How?
 Use tips of 2 fingers or 2 thumbs meeting in midline
 Press down on sternum to depress 1/3-1/2 of the depth of infant
chest

Rate of compression 100/min

Ratio of compression : breathing 5:1
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 Circulation MANAGEMENT

Chest compression
in Small child (1-8 y)
Land mark:
One finger breadth above XSJ

How?
 Use heel of one hand
 Press down on sternum to depress 1/3-1/2 of the depth of child
chest

Rate of compression 100/min

Ratio of compression : breathing 5:1
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 Chest compression

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 Circulation MANAGEMENT

Chest compression
in large child (> 8 y)
Land mark:
2 finger breadth above XSJ

How?
 Use 2 handed method with interlocked fingers
 Press down on sternum to depress 1/3-1/2 of the depth of child
chest

Rate of compression 100/min

Ratio of compression : breathing 15:2
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 PBLS sequences

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 When to Stop resuscitation ??/????

Continue resuscitation until:

1. The victim show signs of life

2. Help arrives

3. One minute then interrupt for 10 second to call

for help

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