PALS Pediatric Advanced Life Support Handbook Latest Rated A+.

PALS Pediatric Advanced Life Support Handbook Latest Rated A+. CHAPTER Any provider attempting to perform PALS is assumed to have developed and maintained competence with not only the materials presented in this handbook, but also certain physical skills, including Basic Life Support (BLS) interventions. Since PALS is performed on children and infants, PALS providers should be proficient in BLS for these age groups. While we review the basic concepts of pediatric CPR, providers are encouraged to keep their physical skills in practice and seek additional training if needed. 6 PALS – Pediatric Advanced Life Support The ILCOR guidelines for PALS highlights the importance of effective team dynamics during resuscitation. In the community (outside a health care facility), the first rescuer on the scene may be performing CPR alone; however, a pediatric arrest event in a hospital may bring dozens of people to the patient’s room. It is important to quickly and efficiently organize team members to effectively participate in PALS. The ILCOR supports a team structure with each provider assuming a specific role during the resuscitation. This consists of a team leader and several team members (Table1). THE RESUSCITATION TEAM 2 CHAPTER Table 1 • Understand their role • Be willing, able, and skilled to perform the role • Understand the PALS sequence • Committed to the team’s success TEAM MEMBER • Organizes the group • Monitors performance • Able to perform all skills • Directs team members • Provides feedback on group performance after the resuscitation efforts TEAM LEADER Clear communication between team leaders and team members is essential. 7 PALS – Pediatric Advanced Life Support It is important to know your own clinical limitations. Resuscitation is the time for implementing acquired skills, not trying new ones. Clearly state when you need help and call for help early in the care of the person. Resuscitation demands mutual respect, knowledge sharing, and constructive criticism. After each resuscitation case, providers should spend time reviewing the process and providing each other with helpful and constructive feedback. Ensuring an attitude of respect and support is crucial and aids in processing the inevitable stress that accompanies pediatric resuscitation (Figure 1). Figure 1 Closed-Loop Communication TEAM LEADER GIVES CLEAR ASSIGNMENT TO TEAM MEMBER TEAM LEADER LISTENS FOR CONFIRMATION TEAM MEMBER RESPONDS VERBALLY WITH VOICE AND EYE CONTACT TEAM MEMBER REPORTS WHEN TASK IS COMPLETE AND REPORTS THE RESULT 2 THE RESUSCITATION TEAM 8 PALS – Pediatric Advanced Life Support Differences in BLS for Infants and BLS for Children INFANTS (0 to 12 months) CHILDREN ( 1 year to puberty) According to the 2020 CPR guidelines, for all ages of children, the new ratio of compressions to ventilations should be 15:2. Check for infant’s pulse using the brachial artery on the inside of the upper arm between the infant’s elbow and shoulder. Check for child’s pulse using the carotid artery on the side of the neck or femoral pulse on the inner thigh in the crease between the leg and groin. Perform compressions on the infant using two fingers (if you are by yourself) or two thumbs with hands encircling the infant’s chest (with two rescuers). Perform compressions on a child using one or two-handed chest compressions depending on the size of the child. Compression depth should be one-third of the chest depth; for most infants, this is about 1.5 inches (4 cm). Compression depth should be one-third of the chest depth; for most children, this is 2 inches (5 cm). If you are the only person at the scene and find an unresponsive infant or child, perform CPR for two minutes before you call EMS or go for an AED. If you witness a cardiac arrest in an infant or child, call EMS and get an AED before starting CPR. Table 2 BASIC LIFE SUPPORT 3 CHAPTER Basic Life Support (BLS) utilizes CPR and cardiac defibrillation when an Automated External Defibrillator (AED) is available. BLS is the life support method used when there is limited access to advanced interventions such as medications and monitoring devices. In general, BLS is performed until the emergency medical services (EMS) arrives to provide a higher level of care. In every setting, high-quality CPR is the foundation of both BLS and PALS interventions. High-quality CPR gives the child or the infant the greatest chance of survival by providing circulation to the heart, brain, and other organs until return of spontaneous circulation (ROSC). This handbook covers PALS and only briefly describes BLS. All PALS providers are assumed to be able to perform BLS appropriately. It is essential that PALS providers be proficient in BLS first. High-quality BLS is the foundation of PALS. 9 PALS – Pediatric Advanced Life Support BLS FOR CHILDREN (1 YEAR TO PUBERTY) BLS for both children and infants is almost identical. For example, if two rescuers are available to perform CPR, the compression to breath ratio is 15:2 for both children and infants. ONE-RESCUER BLS FOR CHILDREN If you are alone with a child, do the following: 1. Tap their shoulder and talk loudly to the child to determine if they are responsive. 2. If the child does not respond and is not breathing (or is only gasping for breath), yell for help. If someone responds, send the second person to call 911 and to get an AED. 3. Assess if they are breathing while feeling for the child’s carotid pulse (on the side of the neck) or femoral pulse (on the inner thigh in the crease between their leg and groin) for no more than 10 seconds. 4. If you cannot feel a pulse (or if you are unsure), begin CPR by doing 15 compressions followed by two breaths. If you can feel a pulse but the pulse rate is less than 60 beats per minute, you should begin CPR. This rate is too slow for a child.