Pediatric arrest is cardiopulmonary arrest that occurs in children. Pediatric arrest occurs when there is inadequate or absent heart activity. If the heart is not pumping, there is no blood circulating. The cessation of blood circulating will cause a child's death if it is not recognized and reversed. High-quality cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED) are the basic management methods for pediatric arrest
Etiology of Pediatric Arrest
Common causes for pediatric arrest are a respiratory arrest or a sudden cardiac arrest. A child with a respiratory arrest may be only minutes away from a cardiac arrest if early recognition and interventions are not initiated. In a respiratory arrest, oxygen is not being supplied to the tissues and major organs. When oxygen is not being supplied to the brain, the child will lose consciousness and stop breathing. In a true cardiac arrest, there is a dysrhythmia (irregular heart rhythm) that is causing the ineffective or absent pumping of the heart. Cardiac arrests can be caused by a heart abnormality, trauma to the chest, drowning, lightning or electrical shocks or poisons. The dysrhythmia most often associated with a cardiac arrest is called ventricular fibrillation (VF). When a patient is in ventricular fibrillation (VF), the heart is quivering and is not pumping blood. There is no palpable pulse.
Recognition
A child in respiratory arrest will be cyanotic and gasping or breathing irregularly and will have a very slow heart rate. The child with cardiac arrest will have no movement, no breathing and no pulse.
Outcome
Sudden cardiac arrest from a heart dysrhythmia is uncommon in children. The progression of a respiratory arrest is more frequently the cause leading up to a cardiac arrest than a heart dysrhythmia. In a respiratory arrest, the outcomes are good with early recognition and interventions. When cardiac arrest develops in children, the outcome is poor.
Treatment
Cardiac arrest requires cardiopulmonary resuscitation (CPR), chest compressions and ventilation until an automated external defibrillator arrives (AED). Automated external defibrillators (AED) are not recommended for use on children under 1 year of age.
Prevention/Solution
Prevention for cardiopulmonary arrest in children may be possible with cardiovascular medical screenings and treatment of any predisposing problems. Prompt treatment is also key in helping to prevent death. The general public, teachers, parents and coaches need to be aware that sudden cardiac arrest can occur in children should know how to provide cardiopulmonary resuscitation (CPR) until additional help arrives
References
- "Pediatric Advanced Life Support"; American Heart Association; 2006
- "Sheehy's Manual of Emergency Care"; Elseviser / Mosby 6th ed.; 2005
