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[Definitions and prevention of cardiorespiratory arrest in children]
A Carrillo Alvarez1, J López-Herce Cid
1Sección de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, España.
Insights
Cardiopulmonary resuscitation (CPR) guidelines define age groups and criteria for respiratory and cardiac arrest in children. Prevention and public CPR training are key to reducing child mortality from cardiorespiratory arrest.
Area of Science:
- Pediatrics
- Emergency Medicine
- Cardiology
Context:
- Cardiopulmonary resuscitation (CPR) involves specific age divisions: neonates, infants (birth to 12 months), and children (12 months to puberty).
- Accurate definitions for respiratory and cardiac arrest are crucial for timely intervention in pediatric emergencies.
- Understanding the return of spontaneous circulation (ROSC) and its duration is vital post-resuscitation.
Purpose:
- To delineate age-specific classifications within pediatric cardiopulmonary resuscitation.
- To define critical parameters for identifying respiratory and cardiac arrest in children.
- To establish criteria for assessing return of spontaneous circulation after pediatric resuscitation.
Summary:
- Pediatric CPR categorizes patients into neonates, infants, and children, with distinct criteria for respiratory arrest (apnea, agonal gasping) and cardiac arrest (absent pulse, <60 bpm with poor signs).
- Return of spontaneous circulation (ROSC) is defined by pulse recovery or circulatory signs lasting over 20 minutes.
- Common causes of pediatric cardiorespiratory arrest include injuries, sudden infant death syndrome, and respiratory illnesses.
Impact:
- Highlights the importance of standardized definitions in pediatric emergency care.
- Emphasizes that injury, SIDS, and respiratory diseases are primary pediatric arrest etiologies.
- Stresses that prevention and widespread basic CPR training are the most effective strategies to decrease pediatric cardiorespiratory arrest mortality.
Abstract:
In cardiopulmonary resuscitation ages are divided in neonates (in the inmediate period after the birth), infant (from birth to 12 months) and child (from 12 months to puberty). Respiratory arrest is defined by the absence of spontaneous respiration (apnea) or a severe respiratory insufficiency (agonal gasping) that require respiratory assistance. Cardiac arrest is defined as the absence of central arterial pulse or signs of circulation (movement, cough or normal breathing) or the presence of a central pulse less than 60 lpm in a child who does not respond, not breath and with poor perfusion. After resuscitation the return of spontaneous circulation is defined as the recuperation of central arterial pulse or signs of circulation in a child with previous cardiorespiratory arrest. It is maintained when the duration is longer than 20 minutes. Injuries, sudden infant death syndrome, and respiratory diseases are the most frequent etiologies of cardiorrespiratory arrest in children. The prevention and the formation of citizens in basic cardiopulmonary resuscitation are the most effective measures to reduce the mortality of cardiorespiratory arrest in children.
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