1) C-A-B for CPR.Now recommended to start compressions immediately instead of the conventional rescue breaths.
2) Capnography during CPR.Continuous capnography recommended during CPR to guide the resuscitation, especially the effectiveness of chest compressions.
a. If ETCo2 is less than 10 to 15 mm Hg consistently, focus your efforts on improving chest compressions.
3) Etomidate for RSI induction. Okay to use in infants and children, BUT not recommended for pediatric patients in septic shock. Etomidate was not addressed in 2005 guidelines.
4) Cuffed ET tubes. Acceptable to use in infants and children.
5) Limit FiO2 after resuscitation. Keep O2 sats≥94%. Avoid hyperoxia.
6) Therapeutic hypothermia after cardiac arrest. Recommendation based off of adult data, no pediatric prospective RCT done on this. This is beneficial in adolescents with out-of-hospital VF arrest.
a. Consider therapeutic hypothermia for infants and children.
b. Cool to 32oC-34oC
References
1. Kleinman ME, Chameides L, Schexnayder SM, et al. Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122:S876–S908.
