Introduction
In children, cardiac arrest is usually the end of a respiratory or circulatory failure (hypoxia, shock), not a primary heart problem. The heart slows (bradycardia) and stops (asystole or pulseless electrical activity); ventricular fibrillation is uncommon. So oxygen and ventilation come first, and recognising the sick child early prevents most arrests. These notes follow the European Resuscitation Council (ERC 2021) paediatric guidelines.
Paediatric basic life support
- Safety: make the scene safe. Check response (speak, gentle stimulus). Shout for help.
- Airway: open it. Infant: head in neutral position. Child: head tilt and chin lift (jaw thrust if neck injury is possible).
- Breathing: look, listen and feel for no more than 10 seconds. If not breathing normally:
- Give 5 rescue breaths. Infant: mouth over mouth and nose. Child: mouth to mouth, pinching the nose. Watch the chest rise.
- Check for signs of life (movement, coughing, normal breathing) for up to 10 seconds. If none, or a pulse under 60 with poor perfusion: start chest compressions.
- 15 compressions : 2 breaths (healthcare rescuers; a lay rescuer may use 30 : 2).
- If alone with a phone: call emergency services on speaker at once. If alone without a phone: do 1 minute of CPR first, then go for help.
Use an AED as soon as one is available, with paediatric pads or a dose attenuator if under about 8 years (an adult AED is still better than none). Minimise pauses.