Pediatric Resuscitation

administer emergency resuscitation medications. The BLS course focuses only on chest compressions, basic airway interventions, and the use of an automatic external defibrillator. The ACLS course was first launched in 1974 and have been updated in 1980, 1986, 1992, 2000, 2005, 2010, and most recently 2015.

Pulseless patients require immediate initiation of chest compressions. The ACLS protocol outlines when and how often to give epinephrine and when to check the monitor for a shockable rhythm. If a pulseless patient has ventricular tachycardia or ventricular fibrillation, they should be defibrillated, or shocked, to increase their chances of converting to a normal cardiac rhythm that can sustain life.

Adult patients who are severely dehydrated or volume depleted should be resuscitated with isotonic intravenous fluids like normal saline. The usual resuscitation fluid bolus dose is twenty to thirty milliliters per kilogram. Patients who are anemic or who have suffered blood loss from injuries should also be resuscitated with appropriate blood products including packed red blood cells.

While moving through the ACLS algorithm for a cardiac arrest patient, it is also important to check for the so called “H’s” and “T’s” of reversible causes and to take appropriate action if one is found. The H’s include hypoglycemia, hypovolemia, hypoxia, hydrogen ions or acidosis, hyper or hypo kalemia, and hypothermia. The T’s include toxins, cardiac tamponade, tension pneumothorax, thrombosis causing a myocardial infarction, thrombo embolism, and trauma.

PEDIATRIC RESUSCITATION

The resuscitation of children similarly follows the principles and protocols outlined by the PALS guideline, known as pediatric advanced life support. This guideline outlines the sequence of algorithms to treat respiratory arrest, shock, and arrhythmias that commonly present in children. The protocol discusses chest compressions, oxygen ventilation, are vaso-active medications like epinephrine and atropine, and electrical defibrillation. The key difference between PALS and ACLS is the focus on respiratory interventions in PALS since children are more likely to suffer from respiratory problems.

Neonatal resuscitation involves the care for newborn infants over their first hours of life. This care is covered by be the NALS protocol, or neonatal advanced life support.

Dehydrated pediatric patients should be resuscitated with isotonic fluids like normal saline using a bolus dose of twenty milliliters per kilogram. Patients who are anemic or who have suffered significant blood loss should be resuscitated with appropriate blood products like packed red blood cells. Packed red blood cells can be administered using an initial dose of ten milliliters per kilogram.