TY - CHAP M1 - Book, Section TI - Cardiopulmonary Resuscitation A1 - Inaba, Alson S. A2 - Schafermeyer, Robert A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. Y1 - 2014 N1 - T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 4e AB - The code leader must ensure high-quality cardiopulmonary resuscitation (CPR) be integrated into advanced life-support measures in order to ensure a good outcome during resuscitation.Chest compressions should be initiated before ventilations in order to immediately provide blood flow to the heart and brain (2010 AHA C-A-B recommendations).When two or more health care providers are performing CPR in an infant or child, the correct compression-to-ventilation ratio is 15:2 (15 compressions followed by 2 ventilations). In all other circumstances, the ratio is 30:2.Two-minute cycles of CPR should be performed before stopping compressions to reassess the child.Automated external defibrillators (AEDs) can now be safely and effectively used in infants and children of all ages. If possible use a pediatric attenuator device for children weighing less than 25 kg.Ventricular fibrillation and pulseless ventricular tachycardia are treated with single shocks followed immediately by 2-minute cycles of CPR in order to maintain myocardial perfusion after each defibrillation.Length-based tapes facilitate medication dosing and device size selection.Intraosseous (IO) lines can be used in any age for an IV medication.IV or IO medication administration is preferred over the endotracheal route.Pulseless electrical activity (PEA) requires the identification and correction of reversible causes, the most common of which is hypovolemia. Consider a rapid fluid bolus in any child presenting in a PEA rhythm.The quality of chest compressions can be monitored with continuous monitoring of end-tidal CO2. Less than 10 to 15 mm Hg may indicate low cardiac output during CPR, whereas >10 to 15 mm Hg suggests effective chest compressions during CPR. An abrupt rise in end-tidal CO2 (ETCO2) during chest compressions may suggest the return of spontaneous circulation.After the return of spontaneous circulation, avoid the risk of hyperoxia reperfusion injury. Titrate the oxygen FiO2 administration to maintain oxygen saturations of 94% to 99%. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1105680717 ER -