The Pediatric Chain of Survival

Prevention - Early CPR - Early Activation of EMS - Early ALS

EARLY CPR

The second link in the pediatric chain of survival is early CPR although a critical skill, its application is not necessary for every pediatric patient in an emergency situation. Those who are providing care should assess the victim to determine the most appropriate course of action. The pediatric chain of survival in not the pediatric “cardiac” chain of survival. Children are less likely to suffer from cardiac arrest due to heart disease and most often are found to require emergency medical assistance due to another type of circumstance that has caused them to stop breathing.

In any case what is important to understand is that children cannot survive very long at all without oxygen. For this reason it is important that a lone rescuer who finds a child unresponsive assess the need for rescue breathing or CPR even before spending any time calling 911. Of course when multiple bystanders are present, calling 911 and the assessment of the child’s airway breathing and circulation can be performed simultaneously.

Effective CPR is best when started immediately after the victim’s collapse. Studies consistently show that bystander CPR is most effective at producing the desired result when it is started immediately and has a significantly positive effect on patient survival. The keywords here are “immediately” and “effective”. Poor CPR is almost as good as no CPR. Chest compressions need to be fast and hard in order to do the job right.

CPR includes chest compression and breaths. Currently as of this article, the ratio of compressions to breaths for CPR for the pediatric victim is 30 to 2 (30 compressions for every 2 breaths). CPR keeps oxygen rich blood flowing to the heart which keeps vital organs alive, buying the victim some time before advanced personnel arrive and take over. This can make the difference between a victim going home brain dead (if at all) or going home in a neurologically sound condition.

We like success in dealing with emergencies when is comes to our children. We want to respond correctly and effectively when the time comes. This is done by correct training and education. Training is in the prevention link of the pediatric chain of survival. In the event that CPR is needed for a child, training can keep us from doing the wrong thing and quite possibly give someone’s child the best chance of survival.

Michael Morales EMT-Paramedic

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