IV-158 Circulation December 13. 2005 No or response Send someone to phone 911, get AED For SUDDEN COLLAP ONE 911, Get AED Open AIRWAY, check BREATHING If not breathing. give 2 BREATHS that make chest rise within 10 seconds? Recheck pulse every Ne plan Figure 2. Pediatric Healthcare Provider BLS Algorithm. Note that the boxes bor- dered by dotted lines are performed by Push hard and fast (100/n healthcare providers and not by lay rescuers. Two Rescuers: Give cycles of 15 COMPRESSIONS and 2 BREATHS If not already done, PHONE 911, for child get AED/defibrillator Infant (<1 year Continue CPR until ALS responders take over or Child (l year): Continue CPR; use AEDMdefbrillator after 5 cycles of CPR Use AED as soon as it is available for sudden, witnessed collapse) Check rhyl Shockable rhythm? Resume CPR immediately for 5 cycles victim starts to move Approximately 2% of all victims with blunt trauma requir- If the child is breathing and there is no evidence of trauma ing spinal imaging in an emergency department have a spinal turn the child onto the side(recovery position, Figure 3). injury. This risk is tripled if the victim has craniofacial This helps ma n a patent airway and decreases risk of injury, 48 a Glasgow Coma Scale score of <8, 9 or both. 48.50 If you are a healthcare provider and suspect that the victim may have a cervical spine injury, open the airway using a jaw thrust without head tilt(Class lIb).46.51. 2 Because maintaining Give Rescue Breaths(Box 4) a patent airway and providing adequate ventilation is a pri- If the child is not breathing or has only occasional gasp ority in CPR(Class I), use a head tilt-chin lift maneuver if the jaw thrust does not open the airway For the lay rescuer: maintain an open airway and give 2 breaths For the healthcare provider: maintain an open airway Check Breathing(Box 3) and give 2 breaths. Make sure that the breaths are While maintaining an open airway, take no more than 10 seconds to ffective(ie, the chest rises ). If the chest does not rise check whether the victim is breathing: Look for rhythmic chest and eposition the head, make a better seal, and try again. 55 abdominal movement, listen for exhaled breath sounds at the nose It may be necessary to move the childs head through a and mouth, and feel for exhaled air on your cheek. Periodic gasping range of positions to obtain optimal airway patency and also called agonal gasps, is not breathing.5354 effective rescue breathing.Approximately 2% of all victims with blunt trauma requir￾ing spinal imaging in an emergency department have a spinal injury. This risk is tripled if the victim has craniofacial injury,48 a Glasgow Coma Scale score of 8,49 or both.48,50 If you are a healthcare provider and suspect that the victim may have a cervical spine injury, open the airway using a jaw thrust without head tilt (Class IIb).46,51,52 Because maintaining a patent airway and providing adequate ventilation is a pri￾ority in CPR (Class I), use a head tilt– chin lift maneuver if the jaw thrust does not open the airway. Check Breathing (Box 3) While maintaining an open airway, take no more than 10 seconds to check whether the victim is breathing: Look for rhythmic chest and abdominal movement, listen for exhaled breath sounds at the nose and mouth, and feel for exhaled air on your cheek. Periodic gasping, also called agonal gasps, is not breathing.53,54 ● If the child is breathing and there is no evidence of trauma: turn the child onto the side (recovery position, Figure 3). This helps maintain a patent airway and decreases risk of aspiration. Give Rescue Breaths (Box 4) If the child is not breathing or has only occasional gasps: ● For the lay rescuer: maintain an open airway and give 2 breaths. ● For the healthcare provider: maintain an open airway and give 2 breaths. Make sure that the breaths are effective (ie, the chest rises). If the chest does not rise, reposition the head, make a better seal, and try again.55 It may be necessary to move the child’s head through a range of positions to obtain optimal airway patency and effective rescue breathing. Figure 2. Pediatric Healthcare Provider BLS Algorithm. Note that the boxes bor￾dered by dotted lines are performed by healthcare providers and not by lay rescuers. IV-158 Circulation December 13, 2005