PE24.{1,21} | Cardiorespiratory Arrest — Summary & Reflection

KEY TAKEAWAYS

Cardiorespiratory arrest in children is predominantly secondary to respiratory failure or shock, not primary arrhythmia. Recognition requires confirming unresponsiveness, absent normal breathing, and absent pulse within 10 seconds. Paediatric BLS uses the C-A-B sequence: compressions at 100–120/min to one-third AP depth (~4 cm infant, ~5 cm child), ratio 30:2 (single rescuer) or 15:2 (two rescuers). Defibrillation (2–4 J/kg) is used only for shockable rhythms — VF and pVT. Adrenaline 0.01 mg/kg IV/IO is the key drug for all arrest rhythms. Post-ROSC care targets SpO₂ 94–99%, normocapnia, normoglycaemia, haemodynamic support, and prevention of fever. Quality of BLS — particularly uninterrupted compressions at correct depth — is the single most modifiable determinant of survival.

REFLECT

Think about a recent ward round or emergency exposure. Was there a child who seemed 'unwell' but whose deterioration was not escalated urgently? What signs might have indicated peri-arrest status? How would you have communicated your concern to a senior colleague using a structured tool (e.g., SBAR: Situation, Background, Assessment, Recommendation)? Reflect on how the cognitive load of performing BLS while directing a team can be reduced through regular simulation practice — what specific aspect of the BLS skill do you most need to practise before your first real resuscitation?