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Pediatric Resuscitation Guidelines Announced by ILCOR

Feb 17, 2011

The 2010 International Liaison Committee on Resuscitation Pediatric Task Force has updated the 2005 treatment recommendations for pediatric resuscitation.
The 2010 International Liaison Committee on Resuscitation Pediatric Task Force has updated the 2005 treatment recommendations for pediatric resuscitation. Highlights include the following:

. Initiate cardiopulmonary resuscitation (CPR) if there are no signs of life and a pulse is not palpated within
10 seconds.
. Provide conventional CPR (chest compressions with rescue breathing).
. Compress at least one third of the anterior-posterior dimension of the chest.Modify or discontinue cricoid
pressure if it impedes preintubation ventilation or intubation.
. Monitor capnography to confirm endotracheal tube position, recognizing that end-tidal CO2 in infants and
children might be below detectable limits for colorimetric devices (85% sensitivity and 100% specificity).
. Consider use of an esophageal detector device in children weighing >20 kg.
. Use capnography monitoring to assess effectiveness of chest compressions.
. Avoid excessive ventilation, which can decrease cerebral perfusion pressure, rates of return of
spontaneous circulation (ROSC), and survival rates.
. After ROSC, titrate oxygen concentration to limit the risk for toxic oxygen byproducts.
. For pediatric septic shock, include therapy directed at normalizing central venous oxygen saturation to
70%.
. Do not routinely use bicarbonate or calcium for pediatric cardiac arrest: Both agents are associated with
decreased survival.
. Consider using cuffed tracheal tubes in infants and young children; cuff pressure should not exceed 25 cm
H2O. Appropriate sized tubes by age are as follows:
— 3 mm for age 1 year
— 3.5 mm for age 1–2 years
— Age in years/4 + 3.5 mm for age >2 years