The physiology behind resuscitation guidelines

The guidelines for infant and paediatric resuscitation have been made by international consensus, following review of all available research data to date. Information is limited. In young children, respiratory arrest usually precedes cardiac arrest. Basic life support with five rescue breaths should be given for at least 1 min before activating the emergency-medical system. In older children and adults, underlying pathology is potentially different and help should be sought immediately. The preferred method for cardiac compressions in infants is with the hand-encircling method, but two finger compressions continue to be recommended for single or lay rescuers. In children, the recommended rate is 15 compressions to two rescue breaths for all ages, whatever the number of rescuers. One defibrillating shock is now recommended, and automated external defibrillators, equipped for dose attenuation, may be used in infants and young children. Drugs should be given intravascularly. High-dose adrenaline is not recommended in cardiac arrest as there are significant adverse effects.