Professional Documents
Culture Documents
Cognitive Objectives (1 of 3)
C D
Airway Obstruction
• Croup
– A viral infection of the airway below the level of
the vocal cords
• Epiglottitis
– Infection of the soft tissue in the area above the
vocal cords
• Foreign body airway obstructions
Signs and Symptoms
• Decreased or absent breath
sounds
• Stridor
• Retractions
• Difficulty speaking
Signs of Complete
Airway Obstruction
• Signs and symptoms
– Ineffective cough (no sound)
– Inability to cry
– Increasing respiratory difficulty, with stridor
– Cyanosis
– Loss of consciousness
Removing a Foreign Body Airway
Obstruction (1 of 5)
• In an unconscious child:
– Place the child on a firm, flat surface.
– Inspect the upper airway and remove any
visible object.
– Attempt rescue breathing.
– If ventilation is still unsuccessful, position
hands on the abdomen.
Removing a Foreign Body Airway
Obstruction (2 of 5)
• Give five abdominal thrusts.
• Open airway again to try and
see object.
• Only try to remove object if
you see it.
• Attempt rescue breathing.
Removing a Foreign Body Airway
Obstruction (3 of 5)
• If unsuccessful, reposition
head and attempt
ventilation again.
• Repeat abdominal thrusts if
obstruction persists.
Removing a Foreign Body Airway
Obstruction (4 of 5)
• In a conscious child:
– Kneel behind the
child.
– Give the child five
abdominal thrusts.
– Repeat the technique
until object comes out.
Removing a Foreign Body Airway
Obstruction (5 of 5)
• If the child becomes
unconscious, inspect the
airway.
• Attempt rescue
breathing.
• If airway remains
obstructed, repeat
thrusts.
Management of Airway
Obstruction in Infants
• Hold the infant facedown.
• Deliver five back blows.
• Bring infant upright on the thigh.
• Give five quick chest thrusts.
• Check airway.
• Repeat cycle as often as
necessary.
Neonatal Resuscitation
• Resuscitation measures include:
– Positioning airway
– Drying
– Warming
– Suctioning
– Tactile stimulation
Neonatal Equipment
Additional Efforts
• Deliver chest compressions
at 120 per minute.
• Coordinate chest
compressions with
ventilations at a ratio of 3:1.
• If meconium is present,
suction infant vigorously.
BLS Review
• Cardiac arrest in children is commonly due to
respiratory arrest.
• Many causes of respiratory arrest
• For purposes of pediatric BLS:
– Infancy ends at 1 year of age.
– Childhood extends to 8 years of age.
– Children older than 8 years of age are
treated as adults.
Determine Responsiveness
• Gently tap on shoulder and speak loudly.
• If responsive, place in position of comfort.
• If you find an unresponsive child when you are not
on duty:
– Provide BLS for about 1 minute.
– Call EMS system.
Airway
• Airway may be obstructed by tongue.
• Use head tilt-chin lift technique or jaw-thrust
maneuver to open the airway.
• Jaw-thrust maneuver is safer if possibility of
neck injury exists.
Breathing
• Look, listen, and feel.
• Provide rescue
breathing if needed.
• Perform Sellick
maneuver to prevent
gastric distention.
Circulation
• Assess circulation after airway is open and two
rescue breaths have been given.
• Check for pulses.
• Evaluate for other signs of circulation.
• Do not spend more than 10 seconds trying to find a
pulse.
Infant CPR (1 of 2)
• Place infant on firm
surface and maintain
airway.
• Place two fingers in the
middle of the sternum.
• Use two fingers to
compress the chest about
1/2" to 1" at a rate of
100/min.
Infant CPR (2 of 2)
• Allow sternum to return briefly to its normal
position between compressions.
• Coordinate rapid compressions and
ventilations in a 5:1 ratio.
• Reassess the infant for return of breathing and
pulse after 1 minute, then every few minutes.
Child CPR (1 of 2)
• Place child on firm
surface and maintain
airway with one hand.
• Place heel of other
hand over lower half of
the sternum.
– Avoid the xiphoid
process.
• Compress chest about
1" to 1 1/2" at a rate of
100/min.
Child CPR (2 of 2)
• Coordinate compressions with ventilations in
a 5:1 ratio, pausing for ventilations.
• Reassess for breathing and pulse after about
1 minute and then every few minutes.
• If the child resumes effective breathing, place
child in recovery position.
AED Use in Children
• Children over 8 should use the adult AED protocol.
• Children ages 1-8:
– 1 minute of CPR before AED
– Use AED with pediatric capabilities.
– Adult AED may be used in local protocols.
• Do not use on an infant under 1 year old.
Trauma (1 of 2)