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Paeds Casesacute-care-resuscitation-and-toxicology

Paeds Cases · acute-care-resuscitation-and-toxicology

Hypothermic submersion cardiac arrest — OSCE

OSCE on the resuscitation of a child in profound hypothermic submersion cardiac arrest, testing the rescue-breath-first sequence, the Swiss staging, the rewarming ladder, the hypothermic defibrillation and drug rules, and the principle of resuscitating until warm.

osce paediatric resuscitation scenario3 min readVerification in progress

Target exams

MRCPCH ClinicalRACP DCERCPSC Pediatrics
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Study tools

Target exams

MRCPCH ClinicalRACP DCERCPSC Pediatrics
Prompt
An 8-year-old is brought to the emergency department after falling through ice into a lake with a submersion of approximately thirty minutes; the child is cold, pale and pulseless, cardiopulmonary resuscitation is in progress, intraosseous access is in place, the core temperature reads 25 degrees Celsius, and the monitor shows ventricular fibrillation; the candidate must lead the resuscitation, apply the hypothermic defibrillation and drug rules, choose the rewarming strategy including extracorporeal rewarming, and state when resuscitation may be terminated.

Station brief (8–10 minutes)

An 8-year-old is brought to the emergency department by ambulance after falling through ice into a lake. Submersion was approximately thirty minutes. The child is cold, pale, and pulseless. Cardiopulmonary resuscitation is in progress by paramedics. Intraosseous access is in place. The core temperature reads 25 degrees Celsius, and the monitor shows ventricular fibrillation. You are the registrar leading the resuscitation, with a skilled nurse and a junior doctor present. Apply the hypothermic defibrillation and drug rules, choose the rewarming strategy, and state when resuscitation may be terminated. Name the source for each threshold. [5] [6]

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References5ShowHide
  1. [1]van Beeck EF A new definition of drowning: towards documentation and prevention of a global public health problem. Bull World Health Organ, 2005.PMID 16302042
  2. [5]Lott C European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation, 2021.PMID 33773826
  3. [6]Brown DJ Accidental hypothermia. N Engl J Med, 2012.PMID 23150960
  4. [8]Saczkowski RS Prediction and risk stratification of survival in accidental hypothermia requiring extracorporeal life support: An individual patient data meta-analysis. Resuscitation, 2018.PMID 29580960
  5. [9]Anadolli V Management of hypothermic submersion associated cardiac arrest in a 5-year-old child: A case report. Resusc Plus, 2021.PMID 34485955
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