Pediatric Cardiac Arrest Question

[nurseglitter]

I had a test question in my peds class yesterday which read, " in management of cardiac arrest what should be the first procedure to perform? Possible answers where: A) Establishment of Airway, B)Chest Compressions, C) Defibrillation or D) Administration of IV adrenaline

I chose Chest compressions and I was wrong :|

My roomate- whose account I'm using is not home to help me and I am very confused:uhoh3: because @ my BLS class the instructor taught us to always do chest compressions first and claimed that it was the new AHA standards of CPR. Any help would be appreciated thank you in advance. :redpinkhe

[RNKPCE]

I think in PALS the biggest emphasis is put on airway, airway, airway. A high percentage of pediatric emergencies are based on breathing issues.

Why did they put chest compressions as an answer twice?

[ImThatGuy, BSN, RN]

I think in PALS the biggest emphasis is put on airway, airway, airway. A high percentage of pediatric emergencies are based on breathing issues.

Why did they put chest compressions as an answer twice?

Well, batmilk said almost exactly what I was gonna say...

[NICU<3RN]

The protocol would be for PALS: first CPR via BLS standard, then defib, then CPR, then if rhythm persists defib again, CPR + administer epi, then if rhythm persists defib, CPR + lidocaine or amiodarone.. repeat epi.. etc..

BTW.. you ARE correct.. the new 2010 guidelines for CPR are "CAB" with compressions first.. perhaps your instructor hasn't caught up yet.. previously it was ABC.. Airway first, then Breathing, then Compressions.. So Airway should be the correct answer (previously).

I think it would be worth arguing with your instructor if you could find a print out guide of the new 2010 AHA guidelines. :)

[aerorunner80, ADN, BSN, MSN, APRN]

Remember this in any situation where a patient goes down....

No airway = No patient.

You can do chest compressions until the cows come home and use the air in the lungs from the last breath but eventually that oxygen gets used up, the CO2 will build up because your airway is blocked (no exhalation) and your patient will die if no air exchange is able to happen.

[Prettyladie]

We were always taught, ABC. Airway, Breathing, Circulation. Airway is the FIRST thing you must do.

[NICU<3RN]

Yes, but the OP is correct.. the 2010 standard for the AHA is "CAB" Compression, Airway, Breathing..

Please see this link from AHA website.. Section ABC or CAB?

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S862

[ImThatGuy, BSN, RN]

Yeah, we've all heard of CAB. I didn't think that was switched over for the peds yet.

[nurse2033, MSN, RN]

The real answer is- depends on the cause. There isn't enough information in the stem to make a good decision. If it is a witnessed arrest into Vfib then defib is the answer. If it is a child choking in the waiting room it is airway. If it is a medical unwitnessed arrest then chest compressions. The only real wrong answer is D, epi would never be the FIRST choice of interventions.

[TravelinCEN]

As a PALS instructor, I can tell you the new and current standard according to the 2010 Guideline is C-A-B.

However, was it witnessed or unwitnessed....yada yada yada....cause....

Try to argue the question, every point counts. Continue repeating the phrase "current guidelines" and stick with your guns.

If the prof counters that she "it has always been ABC." Remind her that "bleeding"was once the cure for everything.

If she still won't give you the points, have her call me :)

Good Luck!

[ImThatGuy, BSN, RN]

I need to do PALS. There's something else to put on my to do list. Blah. Renew ACLS too. Boring.

[lactamase]

the question immediately stated cardiac arrest. your answer is correct according to the new guidelines.

though in reality I'd give a quick check for airway before making myself busy with compressions