I struggled to find PEM resources for my CT3 year, despite the variety of excellent resources out there. I hope this website will help point you in the right direction. I'm not a PEM expert, but am following the guidance CEM have issued (in the form of a syllabus) to put together this page. This page is not endorsed by CEM, and any mistakes are mine.

Please comment with corrections, additions and further suggestions.

All the information here is collected from the internet, and it might be out of date or inaccurate, so please use your judgement and adhere to your hospital's protocols. If you do notice any errors or omissions please comment so we can put them right!

To navigate, decide whether you want to start with a PMP or a PAP. You can then select which PMP or PAP you want to look at. You will then be taken to the summary page for that PMP, with links expanded topic collections. If you know what topic you want to look at already, click on the link on the right hand side.

Tuesday, 6 August 2013

Cardiac Arrest in Children - aetiology

There are two types of cardiac arrest in adults, and children.

Primary Cardiorespiratory Arrest: due to an underlying cardiac arrhythmia (eg VF or VT) is more frequent in adults. The onset is often acute and unpredictable. Immediate defibrillation is needed.

Secondary Cardiorespiratory Arrest is more common in children and is because the body can't deal with the underlying injury or illness.
The pre-terminal rhythm in children is often bradycardia which leads to asystole or PEA - non shockable rhythms.

The outcome from cardiorespiratory arrest in children is poor, especially if there is a prolonged duration. Compared to adults, children are physiologically different but like adults, early recognition of the seriously ill child can prevent sudden death.

Some conditions are more likely to affect children than adults, and more likely to cause their arrest:
Croup: remember a narrower tracheal tube than would normally be expected may be required.
Epiglottitis: you must keep the child calm until the airway is secure.
Anaphylaxis: give adrenaline as quickly as possible

Drowning, electrocution and hypothermia can also affect children, and cause cardio-respiratory arrest. In an arrest situation, the standard CPR algorithms should be followed.

Survival rates remain poor, with survival rates of 0 - 38% quoted in the literature.

No comments:

Post a Comment