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- 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
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 |
Infant | 30 to 60 |
Toddler | 24 to 40 |
Preschooler | 22 to 34 |
School-age child | 18 to 30 |
Adolescent | 12 to 16 |
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
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
+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].