Advanced paediatric life support

Disclaimer

These guidelines have been produced to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. They are not strict protocols, and they do not replace the judgement of a senior clinician. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline.

Read the full PCH Emergency Department disclaimer.

Aim

To guide Emergency Department (ED) staff in the assessment and management of cardiorespiratory arrest.

Key points

This guideline provides a refresher for the algorithms used in paediatric cardiorespiratory arrest. It is not a substitute for hands-on training courses such as the Advanced Paediatric Life Support (APLS) course.

General

Cardiorespiratory arrest in children is less common than in adults. For this reason, all health care providers who work in paediatrics should regularly review the Advanced Paediatric Life Support algorithms to ensure their skills are up to date.

Assessment

Ensure airway, breathing and circulation (ABC) issues are addressed as they are found.
Pause chest compressions briefly to analyse the cardiac rhythm.

Management

Perform continuous cardiopulmonary resusitation (CPR).
Follow non-shockable or shockable algorithm.
Minimise time off chest compressions.
Insert intraosseous needle if no venous access available.
Consider and address 4 H's and 4 T's:
- Hypoxia
- Hypovolemia
- Hypokalemia/Hyperkalemia/Metabolic Disorders
- Hypothermia/Hyperthermia
- Tension pneumothorax
- Tamponade - cardiac
- Toxins
- Thrombosis (pulmonary/coronary).

Refer to

APLS Paediatric Advanced Life Support Algorithms
APLS Paediatric Advanced Life Support Algorithms (with COVID-19 Considerations)

APLS Advanced Paediatric Life Support Algorithms

ALPS Paediatric Advanced Life Support Algorithm

Access the full size PDF

APLS Advanced Paediatric Life Support Algorithms - with COVID-19 considerations

APLS Paediatric Advanced Life Support Algorithms (with COVID-19 Considerations)