N Engl J Med. [Guideline] Nolan JP, Soar J, Cariou A, Cronberg T, Moulaert VR, Deakin CD, et al. It is recommended to increase oxygen concentration to 100 percent if the heart rate continues to be less than 60 bpm (despite effective positive pressure ventilation) and the infant needs chest compressions.57, Initial PIP of 20 to 25 cm H2O should be used; if the heart rate does not increase or chest wall movement is not seen, higher pressures can be used. Standard cardiopulmonary resuscitation versus active compression-decompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiac arrest: a randomised trial. Panchal AR, et al. If a pediatric patient is found to be unresponsive and not breathing in the context of tachycardia on the monitor, then proceed to the pulseless arrest algorithm. This is an area of active research. The dispatcher can instruct you in the proper procedures until help arrives. To perform the BVM or invasive airway technique, the provider does the following: Ensure a tight seal between the mask and the patients face, Squeeze the bag with one hand for approximately 1 second, forcing at least 500 mL of air into the patients lungs. Treat reversible causes. [Guideline] Berg RA, Hemphill R, Abella BS, et al. Endotracheal suctioning may be useful in nonvigorous infants with respiratory depression born through meconium-stained amniotic fluid. An Advanced Cardiac Life Support (ACLS) provider (ie, physician, nurse, paramedic) may also elect to insert an endotracheal tube directly into the trachea of the patient (intubation), which provides the most efficient and effective ventilations. Place your other hand on top of the first hand. Lick CJ, Aufderheide TP, Niskanen RA, et al. Failure to observe chest rise indicates an inadequate mouth seal or airway occlusion. Consider advanced airway placement. Video courtesy of Daniel Herzberg, 2008. Curr Opin Crit Care. Because a range of temperatures is used, the term targeted temperature management (TTM) has been adopted.
