PALS should be immediately performed following pediatric basic life support (PBLS), if possible. SEQUENCE OF PEDIATRIC ADVANCED LIFE SUPPORT Factors predicting the prognosis after ROSCįor neurological prognosis after ROSC in children, it may be necessary to monitor the occurrence of convulsions, examine biochemical markers (neuron specific enolase, S100 protein, lactate, delta neutrophil index ), or perform diffusion-weighted magnetic resonance image (Class IIb, Level C-LD).īlood pressure monitoring and DNI test can be useful to predict discharge and short-term survival in children who have ROSC after IHCA and out-of-hospital cardiac arrests (OHCA) (Class IIb, Level C-LD). In the absence of special consideration, it is reasonable to maintain normal levels of oxygen and CO 2 (Class IIa, Level C-LD). Oxygen and carbon dioxide targets after ROSCįor children who achieve ROSC after CPR, it can be beneficial to measure the partial pressure of arterial oxygen and carbon dioxide (CO 2), and manage them with appropriate goals depending on their condition. When performing targeted temperature management (TTM) in comatose pediatric patients after cardiac arrest, it is effective to set a target temperature of 32☌ to 34☌ or 36☌ to 37.5☌, and actively monitor the body temperature to prevent fever (Class IIa, Level C-LD). Targeted temperature management post-cardiac arrest Waveform capnography monitoring in pediatric IHCA may be considered for predicting a return of spontaneous circulation (ROSC) (Class IIb, Level C-LD). In case of IHCA with non-shockable rhythm, epinephrine should be administered within 5 min after the initiation of chest compressions (Class I, Level C-LD). Factors predicting the outcomes during cardiac arrest Cardiac arrest due to myocarditis or dilated cardiomyopathyįor children with impending or occurring cardiac arrest due to myocarditis or dilated cardiomyopathy, early transfer to a hospital where mechanical circulatory support, such as ECMO and ventricular assist device, is available should be considered (Class IIb, Level C-LD). It is vital to maintain adequate hemodynamics during CPR of infants or children however, the usefulness of invasive hemodynamic monitoring for maintaining systolic and diastolic blood pressure during resuscitation is uncertain (Class IIb, Level C-LD). In case of pediatric in-hospital cardiac arrest (IHCA) with no responsiveness to conventional CPR, resuscitation using extracorporeal membrane oxygenation (ECMO) can be considered depending on the availability of resources in the hospital (Class IIb, Level C-LD).
The first defibrillator dose of 2 J/kg is recommended for shockable rhythms in pediatric cardiac arrest (Class I, Level B-NR). When compared with the 2015 guideline, the changes in the 2020 PALS guidelines are as follows. MAJOR CHANGES IN THE 2020 PALS GUIDELINES Evidence for the revised items that is of high clinical importance and requires additional consideration was reviewed in an acceptable adaptation or hybrid format, and a meta-analysis or scoping review was done. Studies published on PALS were considered in formulating it. These guidelines are based on the scientific consensus and treatment recommendations made in 2020 by the International Liaison Committee on Resuscitation, which establishes the CPR guideline. The 2020 Korean pediatric cardiopulmonary resuscitation (CPR) guidelines refer to the medical recommendations derived from the scientific evidence for pediatric advanced life support (PALS).
Broselow tape 2017 changes license#
14Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Correspondence to: June Dong Park Department of Pediatrics, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea E-mail: 5 2021 21 5 2021 8 S S81 S95 7 03 2021 26 03 2021 28 03 2021 Copyright © 2021 The Korean Society of Emergency Medicine 2021 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( ).
0 kommentar(er)
