TREKK Virtual Education Session - 6 - PALS

PALS Algorithms








Science of Pediatric Resuscitation (2020 Updates)
- Respiratory rates: higher ventilation rates have shown improved rates of ROSC and survival in cardiac arrest
- Infants <1 yr = at least 30 breaths per minute
- Infants >1 yr & children = at least 25 breaths per minute
- With advanced airway in place, target respiratory rate range of 1 breath every 2 to 3 seconds (20-30 per minute)
- Intubation with cuffed ETT is preferred
- Improves capnography and ventilation in patients with poor pulmonary compliance
- Decreases the need for ETT changes
- Improves rate of successful ventilation
- Decreases risk of aspiration
- Cricoid pressure may decrease the success of the first intubation attempt
- Impedes visualization
- Impairs chest rise with bag mask ventilation
- Thus not recommended
- Routine use of epinephrine during CPR aims to improve coronary perfusion pressure and maintain cerebral perfusion pressure
- Earlier administration may increase survival to discharge rates
- Should be started 5 mins after chest compression
- Diastolic blood pressure can be used to assess CPR quality
- Marker of adequate blood flow during CPR if arterial line is in place
- Seizures post cardiac arrest are common, and usually non-convulsive
- Can be detected by EEG
- Recommended when available, and to treat seizures if present