Immediately: No response + no normal breathing → 5 initial rescue breaths, then 15 : 2. Paediatric emergency table for weight, tube and doses: see chapter Paediatric emergency table.
Chest compressions
| Parameter | Infant (< 1 y) | Child (1 y to puberty) |
|---|---|---|
| Technique | 2-thumb technique (encircling) | 1 or 2 hands |
| Compression point | lower half of the sternum | lower half of the sternum |
| Depth | at least ⅓ of the chest diameter (a.–p.) | at least ⅓ of the chest diameter; adolescents 5–6 cm; never > 6 cm |
| Rate | 100–120 /min | 100–120 /min |
| Ratio | 15 : 2 | 15 : 2 |
| Pauses / rescuer change | < 5 s; change the compressor at least every 2 min | < 5 s; change the compressor at least every 2 min |
Sequence
| Shockable (VF / pulseless VT) | Non-shockable (asystole / PEA / bradycardia with poor perfusion) | |
|---|---|---|
| Defibrillation | 4 J/kg (not exceeding the adult dose, 120–200 J depending on the device), resume CPR immediately; refractory (after 5 unsuccessful shocks): stepwise up to 8 J/kg, max. 360 J | – |
| Adrenaline (epinephrine) 10 µg/kg (max. 1 mg) | after the 3rd shock, then every 4 min (2nd dose after the 5th shock) | as early as possible (within 3 min), then every 4 min |
| Amiodarone 5 mg/kg | after the 3rd shock (max. 300 mg), 2nd dose after the 5th shock (max. 150 mg) | – |
Adrenaline (epinephrine) – Resuscitation – children
- 0.01 mg/kg (10 µg/kg) i.v./i.o.[2]max. 1 mg · every 4 min (every 2nd cycle) · 0.1 mg/ml (1 mg made up to 10 ml with NaCl 0.9 %)
10 µg/kg = 0.1 ml/kg of the 0.1 mg/ml dilution. Non-shockable rhythm – as early as possible (within 3 min). Shockable rhythm – after the 3rd and 5th shock, then every 4 min.
Adrenaline (epinephrine) – Resuscitation – children
| BW | 0.01 mg/kg (10 µg/kg) i.v./i.o. · 0.1 mg/ml |
|---|---|
| 3 kg | 0.03 mg 0.3 ml |
| 5 kg | 0.05 mg 0.5 ml |
| 10 kg | 0.1 mg 1 ml |
| 15 kg | 0.15 mg 1.5 ml |
| 20 kg | 0.2 mg 2 ml |
| 25 kg | 0.25 mg 2.5 ml |
| 30 kg | 0.3 mg 3 ml |
| 40 kg | 0.4 mg 4 ml |