ILCOR Advisory Statements: Pediatric Resuscitation -- Figures

ILCOR Advisory Statements: Pediatric Resuscitation -- Figures
Figures 1-5

Maneuver	Adult and Older Child	Young Child	Infant	Newborn	CPR/Rescue
		Approximately 1-8 y	< 1 y	Newly born
					Check Responsiveness
Airway	Head tilt-chin lift(if trauma, use jaw thrust)	Head tilt-chin lift(if trauma, use jaw thrust)	Head tilt-chin lift(if trauma, use jaw thrust)	Head tilt-chin lift(if trauma, use jaw thrust)	Open airway Activate EMS
Breathing					Check breathing
Initial	2-5 breaths at approximately 1 1/2 s per breath	2-5 breaths at approximately 1 1/2 s per breath	2-5 breaths at approximately 1 1/2 s per breath	2-5 breaths at approximately 1 s per breath	If victim breathing recovery position If no chest rise: Reposition and reattempt up to 5 times
Subsequent	12 breaths/min(approximate)	20 breaths/min(approximate)	20 breaths/min(approximate)	30-60 breaths/min(approximate)
Foreign body airway obstruction	Abdominal thrust or back blows	Abdominal thrust or back blows or chest thrusts	Back blows or chest thrusts (no abdominal thrusts)	Suction (no abdominal thrusts or back blows)
Circulation					Assess for signs of life
Pulse check*	*Carotid	*Carotid	*Brachial	Umbilical	if pulse present but breathing absent: Provide rescue breaths If pulse not confidently felt >60/min and poor perfusion: chest compressions
Compression landmarks	Lower half of sternum	Lower half of sternum	1finger's width below intermammary line	*1finger's width below intermammary line
Compression method	#Heel of one hand, other hand on top	Heel of 1 hand	2 or 3 fingers	*2 fingers or encircling thumbs
Compression depth	Approximately 1/3 depth of chest	Approximately 1/3 depth of chest	Approximately 1/3 depth of chest	*Approximately 1/3 depth of chest
Compression rate	Approximately 100/min	Approximately 100/min	Approximately 100/min	*Approximately 120/min	Continue BLS integrate procedures appropriate for newborn, pediatric or adult ALS at earliest opportunity
Compression/ ventilation ratio	15:2 (1 rescuer) 5:1 (2 rescuers)	5:1	5:1	*3:1

Figure 1. Comparison of resuscitative interventions for newborns, infants, children, and adults. CPR indicates cardiopulmonary resuscitation; EMS, emergency medical services; BLS, basic life support; and ALS, advanced life support. *Interventions recommended for suitably trained healthcare providers only.

注：HP では，ここは Heel of open hand, ... となっております。しかし，European Resuscitation Council Guidelines for Resuscitation の記載に従いました。

Figure 2.（原図）

.	ILCOR	AHA	HSFC	EAC	RCSA	ARC
Initial shock	2 J/kg	2 J/kg	2 J/kg	2 J/kg	2 J/kg	2 J/kg
Second shock	2-4 J/kg	4 J/kg	4 J/kg	2 J/kg	2 J/kg	2-4 J/kg
Third shock	2-4 J/kg	4 J/kg	4 J/kg	4 J/kg	4 J/kg	4 J/kg
First medication	Epinephrine (adrenaline) 0.01 mg/kg	Epinephrine 0.01 mg/kg	Epinephrine 0.01 mg/kg	Adrenaline 0.01 mg/kg	Adrenaline 0.01 mg/kg	Adrenaline 0.01 mg/kg
Shocks after first medication	4 J/kg Up to 3 shocks	4 J/kg x 1 shock	4 J/kg x 1 shock	4 J/kg x 3 shock	4 J/kg x 3 shock	4 J/kg x 3 shock
Second medication	Epinephrine (adrenalin)	Epinephrine and lidocaine	Epinephrine	Adrenaline and lignocaine	Adrenaline and lignocaine	Adrenaline
Shocks after second medication	4 J/kg Up to 3 shocks	4 J/kg x 1 shock	4 J/kg x 1 shock	4 J/kg x 3 shock	4 J/kg x 3 shock	4 J/kg x 3 shock

Figure 2. Examples of minor differences in recommendations for treatment of ventricular fibrillation and pulseless ventricular tachycardia between the International Liaison Committee on Resuscitation (ILCOR), the American Heart Association (AHA), the Heart and Stroke Foundation of Canada (HSFC), the European Resuscitation Council (ERC), the Resuscitation Councils of Southern Africa (RCSA), and the Australian Resuscitation Council (ARC).

Figure 3.（原図） Universal pediatric basic life support (BLS) template for lay rescuers. **Continue rescue breathing and cardiopulmonary resuscitation as indicated. Activate emergency medical services as soon as possible, based on local and regional availability.

Figure 4.（原図） Universal pediatric template for pediatric healthcare providers. VF indicates ventricular fibrillation; VT, ventricular tachycardia; defib, defibrillation; CPR, cardiopulmonary resuscitation; and ECG, electrocardiogram.

Figure 5.（原図） Universal newborn (newly born) template. *Advanced life support interventions recommended for suitably trained healthcare providers only: pulse check, chest compressions, endotracheal suction and intubation, vascular access, and epinephrine administration.