Pediatric Basic and Advanced Life Support: An Update on Practice and Education

This review aims to summarize the major changes in the2010 Heart and Stroke foundation of Canada (HSFC) andthe American Heart Association (AHA) Pediatric Basic andAdvanced Life Support Guidelines. The Guidelines were based onthe International Liaison Committee on Resuscitation’s (ILCOR)comprehensive, evidence-based review of the resuscitationliterature. The key recommendations from the Guidelines include:the removal of “look, listen and feel” and a de-emphasis on theuse of the pulse check by healthcare providers to diagnose cardiacarrest; a change in the sequence of resuscitation for patientsin cardiac arrest from the previously well-known “A-B-C” i.e.Airway, Breathing, and Chest Compressions to “C-A-B” i.e.Chest Compressions first; modification to the appropriate depthof compression (at least 1/3 of the anterior-posterior depth of thechest wall or about 4 cm in infants and 5 cm in children); end-tidalCO2 monitoring (in intubated patients) to assess the quality ofchest compressions and optimize cardiopulmonary resuscitation(CPR); and titrating Fi0O2 once “Return of SpontaneousCirculation” (ROSC) is achieved to maintain an oxygen saturationbetween 94-99%. Overall, pediatricians, family and communityphysicians who may care for acutely ill children should be aware ofthese updated guidelines in order to provide the best possible careto their patients.