CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries CRACKCast E010 - Pediatric Resuscitation
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Feb 29, 2016 Tristan Jones, a PGY2 physician specializing in pediatric resuscitation, joins to walk through infant CPR technique and PALS algorithms. They cover compression/ventilation ratios, cardiac arrest rhythms, bradycardia and tachycardia management, shock and vasoactive strategies, key pediatric drug doses, SIDS prevention and ED management, ALTE causes and workup, and pediatric intubation tips.
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Compression Ventilation Ratios By Rescuer
- Pediatric compressions differ by rescuer number: single rescuer 30:2, two rescuers 15:2, neonates 3:1.
- After advanced airway placement aim for 8–10 breaths per minute.
PALS Approach To Pediatric Bradycardia
- For unstable bradycardia with poor perfusion start oxygen/assisted ventilation, begin CPR if HR<60 with signs of poor perfusion, and give epinephrine 0.01 mg/kg IV/IO.
- Consider atropine 0.02 mg/kg (min 0.1, max 0.5 mg) and pacing if needed.
Managing Pediatric Tachycardia And SVT
- For pediatric tachycardia assess stability and QRS width; unstable → immediate synchronized cardioversion starting 0.5–1 J/kg then 2 J/kg.
- For stable narrow SVT try vagal maneuvers then adenosine 0.1 mg/kg (max 6 mg) then 0.2 mg/kg (max 12 mg).