American heart association pediatric advanced life support

Q: How do you perform CPR on a child AHA?

Initiate CPR in an infant or child who is unresponsive, has no normal breathing, and has no definitive pulse after 10 seconds. Start chest compressions before performing airway or breathing maneuvers (C-A-B). After 30 compressions (15 compressions, if two rescuers), open the airway and give two breaths.

Q: What are the new 2020 AHA CPR guidelines?

The 2020 AHA guidelines recommend that the first dose of epinephrine be given to a patient with a non-shockable heart rhythm within five minutes of beginning CPR. This recommendation is based on a study of children experiencing cardiac arrest with non-shockable rhythms in a hospital setting.

Q: What is the most current ACLS guidelines?

The AHA and European Resuscitation Council developed the most recent ACLS Guidelines in 2020 and 2021, respectively, using the comprehensive review of resuscitation literature performed by the International Liaison Committee on Resuscitation (ILCOR) [4-6].

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Table of Contents Show

Pediatric BLS Algorithm
Vital Signs in Children
Modified Glasgow Coma Scale for Infants and Children
Pediatric Trauma Score
Pediatric Advanced Life Support (PALS) Algorithms
What are the current CPR guidelines for children?
How do you perform CPR on a child AHA?
What are the new 2020 AHA CPR guidelines?
What is the most current ACLS guidelines?

Pediatric BLS Algorithm
Vital Signs in Children
Modified Glasgow Coma Scale for Infants and Children
Pediatric Trauma Score
Pediatric Advanced Life Support (PALS)
See also: Key Acute Care Pediatric Medications
See also: Basic and Advanced Life Support

Pediatric BLS Algorithm

Pediatric BLS Algorithm (American Heart Association)

Full text article: Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW, Berg RA, Sutton RM, Hazinski MF. Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S862-75.

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Vital Signs in Children

Heart Rate (rate/min)
Age	Awake Rate	Sleeping Rate
Newborn to 3 months	85 to 205	80 to 160
3 months to 2 years	100 to 190	75 to 160
2 to 10 years	60 to 140	60 to 90
>10 years	60 to 100	50 to 90

Respiratory Rate (breaths/min)
Age	Rate
Infant	30 to 60
Toddler	24 to 40
Preschooler	22 to 34
School-age child	18 to 30
Adolescent	12 to 16

Definition of Hypotension by Systolic Blood Pressure and Age
Age	Systolic Blood Pressure
Term neonates (0 to 28 days)	<60 mm Hg
Infants (1 to 12 months)	<70 mm Hg
Children 1 to 10 years (5th BP percentile)	<70 mm Hg + (age in years x 2) mm Hg
Children >10 years	<90 mm Hg

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Modified Glasgow Coma Scale for Infants and Children

	Child	Infant	Score
Eye opening	Spontaneous To speech To pain only No response	Spontaneous To speech To pain only No response	4 3 2 1
Best verbal response	Oriented, appropriate Confused Inappropriate words Incomprehensible sounds No response	Coos and babbles Irritable cries Cries to pain Moans to pain No response	5 4 3 2 1
Best motor response*	Obeys commands Localizes painful stimulus Withdraws in response to pain Flexion in response to pain Extension in response to pain No response	Moves spontaneously and purposefully Withdraws to touch Withdraws to response in pain Abnormal flexion posture to pain Abnormal extension posture to pain No response	6 5 4 3 2 1

*If patient is intubated, unconscious, or preverbal, the most important part of this scale is motor response. Motor response should be carefully evaluated.

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Pediatric Trauma Score

Assessment Component	SCORE
+2	+1	-1
Weight	Weight >20 kg (>44 lb)	10-20 kg (22-44 lb)	<10kg (<22 lb)
Airway	Normal	Oral or nasal airway, oxygen	Intubated, cricothyroidotomy, or tracheostomy
Systolic Blood Pressure	>90 mm Hg, good peripheral pulses and perfusion	50-90 mm Hg, carotid/femoral pulses palpable	<50 mm Hg, weak or no pulses
Level of Consciousness	Awake	Obtunded or any loss of consciousness	Coma, unresponsive
Fracture	None seen or suspected	Single, closed	Open or multiple
Cutaneous	None visible	Contusion, abrasion, laceration <7 cm not through fascia	Tissue loss, any gunshot wound or stab wound through fascia
Totals
Adapted with permission from Tepas JJ, Molitt DL, Talbert JL, et al: The pediatric trauma score as a predictor of injury severity in the injured child. Journal of Pediatric Surgery. 1987;22(1)15.

*PTS > 8 should have 0 % mortality.
All injured children with PTS < 8 should be triaged to an appropriate pediatric trauma center.

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Pediatric Advanced Life Support (PALS) Algorithms

Pediatric Cardiac Arrest Algorithm - Basic (American Heart Association)
Pediatric Cardiac Arrest Algorithm - Advanced (American Heart Association)
PALS Bradycardia Algorithm (American Heart Association)
PALS Tachycardia Algorithm (American Heart Association)
Full text article: Kleinman ME, Chameides L, Schexnayder SM, Samson RA, Hazinski MF, Atkins DL, Berg MD, de Caen AR, Fink EL, Freid EB, Hickey RW, Marino BS, Nadkarni VM, Proctor LT, Qureshi FA, Sartorelli K, Topjian A, van der Jagt EW, Zaritsky AL. Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S876-908.
Newborn Resuscitation Algorithm (American Heart Association)
Full text article: Kattwinkel J, Perlman JM, Aziz K, Colby C, Fairchild K, Gallagher J, Hazinski MF, Halamek LP, Kumar P, Little G, McGowan JE, Nightengale B, Ramirez MM, Ringer S, Simon WM, Weiner GM, Wyckoff M, Zaichkin J. Part 15: neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S909-19.

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What are the current CPR guidelines for children?

Performing Child & Baby CPR.

Position your shoulders directly over your hands and lock your elbows..

Keep your arms straight..

Push down hard and fast about 2 inches at a rate of 100 to 120 per minute..

Allow the chest to return to normal position after each compression..

How do you perform CPR on a child AHA?

Initiate CPR in an infant or child who is unresponsive, has no normal breathing, and has no definitive pulse after 10 seconds. Start chest compressions before performing airway or breathing maneuvers (C-A-B). After 30 compressions (15 compressions, if two rescuers), open the airway and give two breaths.

What are the new 2020 AHA CPR guidelines?

The 2020 AHA guidelines recommend that the first dose of epinephrine be given to a patient with a non-shockable heart rhythm within five minutes of beginning CPR. This recommendation is based on a study of children experiencing cardiac arrest with non-shockable rhythms in a hospital setting.

What is the most current ACLS guidelines?

The AHA and European Resuscitation Council developed the most recent ACLS Guidelines in 2020 and 2021, respectively, using the comprehensive review of resuscitation literature performed by the International Liaison Committee on Resuscitation (ILCOR) [4-6].