8/27/2023 0 Comments Compression to ventilation ratio![]() If an AED is not nearby or available, the rescuer should start CPR while awaiting the arrival of EMS. If the collapse is witnessed, the rescuer should activate EMS and retrieve an AED (or, for ALS, a manual defibrillator) the single rescuer should then use the AED (or manual defibrillator, for ALS) immediately. If the collapse is not witnessed, the rescuer should start CPR (C-A-B) with a ratio of 30 compressions to two breaths after about 2 minutes, if still alone, the rescuer should activate EMS, retrieve an AED, and apply and activate it immediately. Single rescuer: The approach depends on whether or not the sudden collapse is witnessed.If there is no breathing or only gasping and there is no definitive pulse within 10 seconds, guidance is as follows 1: This assessment guides further action depending on the number of rescuers. The rescuer should assess the patient’s breathing and pulse and determine whether the patient is breathing, only gasping, or not breathing while simultaneously checking for a pulse.If the patient is responsive, the rescuer should determine additional medical needs and the necessity for EMS activation based on the patient’s condition. Alternatively, if there are two or more HCPs, one rescuer should continue to care for the patient and a second rescuer should activate EMS and retrieve an automated external defibrillator (AED) and other emergency equipment. If the patient is unresponsive, the rescuer should call for help and activate emergency medical services (EMS) via a mobile device (single rescuer outside of the hospital) or hospital system (e.g., code button). Next, the rescuer should determine the patient’s responsiveness, get aid, and activate the emergency medical response system.First, the rescuer must confirm the scene’s safety.1,5,6Īs healthcare providers (HCPs), pharmacists should follow the sequence of key actions as described in the guidelines when there is an indication to do so 1: The 2020 AHA guidelines address two indications for the use of BLS in critically ill or injured infants and children: cardiac arrest (no pulse) and bradycardia (heart rate <60 beats/minute) with poor perfusion. Therefore, pharmacists should always renew their pediatric CPR certification before expiration and not only review, but also learn to apply, those concepts not discussed in further detail here. However, it must be noted that this is a brief update chiefly of pediatric BLS and does not go into detail regarding pediatric advanced life support (ALS). This article will discuss important updates from the guidelines that pharmacists should be aware of. The guidelines also emphasize that conventional CPR, which has better outcomes compared with compression-only CPR, is preferable. The approach to BLS in infants and children for a single rescuer differs slightly from when two or more rescuers are available (for algorithms, see The 2020 AHA cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) guidelines reaffirm that the compressions-airway-breathing (C-A-B) sequence is still preferred for pediatric CPR. These differences are specified for infants (age <1 year) and children (age 1 year to start of puberty ). In particular, the pediatric BLS guidelines differ according to patient age and other factors. The American Heart Association (AHA) has published frequent updates on pediatric basic life support (BLS), and the International Liaison Committee on Resuscitation (ILCOR) has published annual treatment recommendations based on a body of data. Pharmacists should be aware of these important changes from previous guidelines, as a growing body of pediatric-specific evidence supports these new recommendations. In infants and children receiving CPR who have an advanced airway in place or who have a pulse but are undergoing rescue breathing, a key update is the recommendation to increase the respiratory rate to 20 to 30 breaths per minute (one breath every 2-3 seconds). In terms of basic life support for pediatric patients, the AHA guidelines continue to emphasize high-quality cardiopulmonary resuscitation (CPR)-i.e., chest compressions of adequate rate and depth, full chest recoil with each compression, minimal interruptions, and avoidance of excessive ventilation. ABSTRACT: The American Heart Association (AHA) guidelines for pediatric basic and advanced life support and the International Liaison Committee on Resuscitation (ILCOR) treatment recommendations were updated in 2020.
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