Search

Objectives: This summary of the European guidelines for pediatric cardiopulmonary resuscitation (CPR) emphasizes the main changes and encourages health care professionals to keep their pediatric CPR knowledge and skills up to date. Basic and advanced pediatric CPR follow the same algorithm in the 2015 guidelines. The main changes affect the prevention of cardiac arrest and the use of fluids. Fluid expansion should not be used routinely in children with fever in the abuse of signs of shock because too high a volume can worsen prognosis. Rescue breaths should last around 1 second in basic CPR, making pediatric recommendations consistent with those for adults. Chest compressions should be at least as deep as one-third the anteroposterior diameter of the thorax. Most children in cardiac arrest lack a shockable rhythm, and in such cases a coordinated sequence of breaths, chest compressions, and administration of adrenalin is essential. An intraosseous canula may be the first choice for introducing fluids and medications, especially in young infants. In treating supraventricular tachycardia with cardioversion, an initial dose of 1 J/kg is currently recommended (vs the dose of 0.5 J/kg previously recommended). After spontaneous circulation is recovered, measures to control fever should be taken. The goal is to reach a normal temperature even before arrival to the hospital.

Aim: To study the current epidemiology, clinical course and outcome of poisonings among children in Oslo and compare findings to a similar study from 1980., Methods: Observational study with prospective inclusion of all children (<15 years of age) with a main diagnosis of acute poisoning treated in hospital or outpatient clinic in Oslo for 2 years., Results: One hundred seventy-five episodes of acute poisoning were included at the outpatient clinic only (n = 65), the paediatric department only (n = 82) or both (n = 28 referrals). Annual incidence was 97 per 100 000, significantly lower than in 1980 (230 per 100 000). Highest incidence was in 1-year-old males (576 per 100 000). In children <8 years of age, the most common toxic agents were pharmaceuticals (39%) and household products (32%); children > or = 8 years ingested mainly ethanol (46%) or pharmaceuticals (36%). Five percent of all children were comatose, and complications were seen in 13%. All children survived without sequelae. Half of the admissions needed treatment; most commonly used treatments were activated charcoal (33%), gastric lavage (9%) and emetics (9%)., Conclusion: The incidence of child poisonings in Oslo has significantly reduced since 1980. Only half of the poisonings needed treatment, most of the poisonings were mild and the clinical outcome was good.

In this article the European Resuscitation Council's guidelines for basic and advanced resuscitation of children are presented. There are some changes from the previous guidelines. Children are divided in three age categories (in addition to the newly born): children up to one year old, one to eight years old, and more than eight years old. In Norway, but not in the rest of Europe, evaluation of the circulation by pulse check has been eliminated in basic, but not in advanced resuscitation. This is due to reports that pulse checks by lay rescuers require much time with poor specificity and sensitivity. In evaluating the patient's own ventilation, the differentiation between agonal gasps and regular breaths is stressed. ECG monitoring provides the link between paediatric basic life support and advanced life support. The algorithm for the latter closely resembles that proposed for adults. While there were previously three separate algorithms for ventricular fibrillation/ventricular tachycardia, asystole and electromechanical dissociation, there is now only one algorithm. Ventilation and chest compressions should be performed for one-minute periods with ventricular fibrillation/ventricular tachycardia, for three-minute periods with other rhythms.

This article presents the new guidelines for resuscitation of the newborn from the European Resuscitation Council. It is estimated that, potentially, 800,000 newborns can be saved each year by simple airways manoeuvres. Personnel trained in basic resuscitation should be present at all deliveries and personnel trained in advanced resuscitation at deliveries with known risk factors. Attention to ventilation is of primary importance. Ventilation should be assisted if stimulation does not achieve a prompt onset of spontaneous respiration and/or the heart rate is less than 100 per minute. Chest compressions--1/3 of the anteroposterior diameter of the chest--should be provided if the heart rate is absent or remains < below 60 per minute despite adequate assisted ventilation for 30 seconds. Chest compressions should be coordinated with ventilation at a ratio of 3:1 and a rate of 120 "events" per minute to achieve approximately 90 compressions and 30 rescue breaths per minute. Adrenalin should be given if the heart rate remains below 60 per minute despite 30 seconds of effective ventilation and chest compression.