New Pediatric Resuscitation Guidelines, October 2020, by the American Heart Association (AHA) Introduce Key Changes to the Resuscitation of Children in Respiratory and/or Cardiorespiratory Arrest
This Guideline Knowledge Check reviews the new Pediatric Advanced Life Support Guidelines (PALS Guidelines) published in October 2020 by the American Heart Association (AHA) that introduce a few key changes to the resuscitation of children in respiratory and/or cardiorespiratory arrest.
Today’s Guideline Knowledge Check question comes from the desk of Med-Challenger Emergency Medicine Editor-in-Chief, Andrea Eberly, MD, FAAEM.
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Try this pediatric resuscitation patient case question and find out if you’re following the most current PALS guidelines.
A 3-year-old boy is brought by his parents to the emergency department for unresponsiveness.
They say that his 4-year-old sibling put a plastic bag over his head; the parents became aware of this when the older sibling screamed for help about 15 minutes ago.
No CPR has occurred.
Upon arrival, the patient is unresponsive.
According to the just released 2020 Pediatric Advanced Life Support (PALS) guidelines, how should he be resuscitated?
If the boy is in respiratory arrest with a pulse, ventilations should be given at the slower rate of 1 breath per 6 seconds (change from previous guidelines, which recommended the same 1 breath per 3 seconds for full pediatric cardiac arrest as well as pediatric respiratory arrest with pulse).
If the boy is in cardiorespiratory arrest and an advanced airway has been placed, ventilations should be delivered asynchronously to chest compressions at 1 breath per 2-3 seconds (changed from previous guidelines, which recommended 1 breath per 6 seconds for intubated pediatric patients in cardiac arrest).
If the boy is in cardiorespiratory arrest, bag valve-mask ventilations prior to intubation should be delivered asynchronously to chest compressions at 1 breath per 6 seconds (change from previous guidelines which recommend synchronized pre-intubation ventilations at 30 compressions to 2 ventilations ratio).
If the boy is in cardiac arrest, cricoid pressure should be applied during intubation to decrease the risk of aspiration (new study strengthens previous guidelines, elevating this recommendation from a Class IIA to Class I).
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About Guideline Knowledge Checks:
With each update of national clinical practice guidelines, some recommendations change and many remain unchanged. Med-Challenger Guideline Knowledge Checks help you know both what is new and what has stayed the same in the most recent guidelines pertinent to each medical specialty.
About the Author:
Andrea Eberly, MD, FAAEM graduated from the David Geffen Medical School of Los Angeles (UCLA) and completed her residency in Emergency Medicine at the University Medical Center, Tucson, Arizona. After working as an attending physician in Tucson, she followed a recruiting call to the island of Guam, where she served in various roles, including as the director of the emergency department, the EMS Medical Director of Guam, and the Director of the 911 Call System. She has maintained her emergency medicine board certification through three cycles of American Board of Emergency Medicine Board Exams (last in 2014), all three with the help of Med-Challenger.
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