Pediatric CPR with Poor Perfusion

Paediatric Cardiac Arrest: is there direction to start compressions on paediatrics with HR 60 with signs of poor perfusion?

Great question regarding pediatric resuscitation guidelines. The short answer is YES. If a pediatric patient has a heart rate 60 bpm with signs of poor perfusion, despite effective oxygenatin and ventilation, initiating chest compressions is the standard of care, as outlined by Heart & Stroke Canada and the American Heart Association (AHA) Pediatric Advanced Life Support (PALS) guidelines. Here is how this applies to a PCP in the Northwest Region under ALS PCS 5.4 and the BLS PCS: BLS / PALS Resuscitation Standards Pediatric bradycardia is frequently caused by hypoxia. The initial priority is to provide effective oxygenation and ventilation using a BVM with 100% oxygen. If the heart rate remains 60 bpm with signs of poor perfusion despite effective ventilation, initiate chest compressions (15:2 compression-to-ventilation ratio for two-rescuer CPR) PCP IV Scope of Practice If you are certified under the NWRPCP PCP IV Auxiliary Medical Directive, establishing IV access during peri-arrest management is appropriate, provided it does not interrupt chest compressions, compromise ventilation, or delay rapid transport. Base Hospital Physician (BHP) Consultation and Transport Given the patient's peri-arrest condition, prioritize immediate transport and initiate early consultation with a Base Hospital Physician (BHP) for additional guidance or orders, as required. If the patient progresses to vital signs absent (VSA), transition to the PCP Medical Cardiac Arrest Directive. In Summary: Prioritize effective VENTILATION, initiate CHEST COMPRESSIONS when the heart rate remains 60 bpm with poor perfusion dspite effective oxygenation and ventilation, seek OMC consultation when indicated, and prioritize RAPID TRANSPORT.