Paediatric Advanced Life Support
It is often asked at what age a responder should use the paediatric rather than adult algorithm. This is usually used if the patient is prepubertal.
Paediatric BLS is similar to adult BLS. The key differences are that CPR begins with 5 rescue breaths before assessing further signs of life e.g. for a carotid pulse, and then is followed by a 15:2 ratio of compressions to breaths. Please see the BLS chapter for further details.
As in the adult patient, the AED will prompt the rescuers to attach the pads to the patient’s chest and plug in the connector to the AED. Smaller paediatric pads should be used if possible. If they are not available, then adult pads should be used. In a larger child these can be place in the same anterolateral positions as described for the adult patient, but in smaller children the pads should be placed on the front and back of the patient. The pads often have diagrams on the reverse to assist in remembering the placement positions.
The algorithm is similar for children as for adults, remembering CPR is delivered with 15 compressions to 2 breaths. While using an AED in a patient with a shockable rhythm the AED will deliver the energy set for the size of pads placed on the patient’s chest. If using a manual defibrillator than the nearest setting to 4 joules per kg (4J/kg) should be used. A rough estimate of  a child’s weight is (Age (years) +4) x2.
Paediatric Cardiac arrest Drug Doses
- Adrenaline is 10mcg/kg (0.1mls per kg of 1:10,000 Adrenaline)
- Amiodarone is 5mg/kg