EM · Paediatric resuscitation

The sick child and paediatric resuscitation

Also known as The sick child · Paediatric resuscitation · Paediatric cardiac arrest · Paediatric basic life support · Broselow tape

The sick child is any infant or child with actual or potential physiological failure, and paediatric resuscitation is the structured, weight-based response. Children differ from adults at every step: they compensate with a rising heart rate and intense vasoconstriction while the blood pressure holds, so hypotension is a late and pre-terminal sign; they consume oxygen at twice the adult rate and desaturate within seconds; and every drug, every fluid and every shock is dosed per kilogram, estimated with the Broselow tape or the formula weight equals age plus four times two. The structured approach is airway with cervical-spine control, breathing with oxygen and bag-valve-mask ventilation, then circulation with intra-osseous access, a 10 mL per kilogram fluid bolus and adrenaline 10 micrograms per kilogram. The paediatric arrest is usually asphyxial rather than cardiac, is managed with 15 to 2 cardiopulmonary resuscitation for two rescuers, the two-thumb encircling technique in the infant, and 4 joules per kilogram defibrillation, and runs through shockable and non-shockable loops that mirror the adult algorithm with weight-based doses. ACEM-primary, globally tagged.