Approach to the unconscious child
Václav Vafek
První pomoc – přednáška (aVLPO011, aZLPO011p)
První pomoc – přednáška (aVLPO011, aZLPO011p)2
Learning objectives
̶ Student will learn the algorithm of the approach to an unconscious
child.
̶ Student will learn the differences in the approach to an
unconscious child and an adult.
3
Basic algorithm
No signs
of life?
Not
reacting?
Safety both
of child
and rescuer
Verbal
and tactile
stimulation
Shout
for help
Open the
airway
Not breathing
normally?
5 rescue breaths
15 compression: 2
breaths
S
Safety
S
Stimulate
S
Shout
for help
A
Airway
B
Breathing
C
Circulation
AED
První pomoc – přednáška (aVLPO011, aZLPO011p)
První pomoc – přednáška (aVLPO011, aZLPO011p)4
Classification of the children in BLS
1. infants: newborns → 1 year
2. children: 1 year (10 kg)→ the first signs of adolescence (60 kg)
3. adolescent (~ adults)
První pomoc – přednáška (aVLPO011, aZLPO011p)5
Differences in childhood
̶ body size
̶ lower lung volume
̶ possible difficult mouth-to-mouth ventilation
̶ large head in relation to the body
̶ different position when opening the airway
První pomoc – přednáška (aVLPO011, aZLPO011p)6
Approach to the unconscious child - SSS ABC
SAFETY
• check if the situation is safe for you and for the child
STIMULATE
• verbal stimulation (e.g.: „Are you all right?“)
• tactile stimulation (e.g.: fix the head and shake the hand gently)
• watch the reaction – answer, cry, movement, …
• reaction – check the condition of the child,
call an ambulance if necessary
• NO reaction→ s
První pomoc – přednáška (aVLPO011, aZLPO011p)7
Approach to the unconscious child - SSS ABC
AIRWAY
• turn the child on its back, carefully!
• open the airway
• infants – neutral position of the head
• children→ adolescent – (gently) tilt the head
SHOUT FOR HELP
• shout for help loudly
• someone else can help us (e.g. call ambulance) or get an AED
První pomoc – přednáška (aVLPO011, aZLPO011p)8
Approach to the unconscious child - SSS ABC
První pomoc – přednáška (aVLPO011, aZLPO011p)9
Approach to the unconscious child - SSS ABC
První pomoc – přednáška (aVLPO011, aZLPO011p)10
Approach to the unconscious child - SSS ABC
BREATHING
• 10 sec., we have to find out if the child is breathing normally
• look, listen and feel
• keep the airway open all the time
• gasping breaths are not normal breathing
První pomoc – přednáška (aVLPO011, aZLPO011p)11
Approach to the unconscious child - SSS ABC
BREATHING
B
breathes
normally
call ambulance,
assess breathing
repetitively
doesn‘t breathe
normally
5 rescue
breaths, call
ambulance
První pomoc – přednáška (aVLPO011, aZLPO011p)12
Approach to the unconscious child - SSS ABC
BREATHING
B
breathes
normally
call ambulance,
assess breathing
repetitively
doesn‘t breathe
normally
5 rescue
breaths, call
ambulance
První pomoc – přednáška (aVLPO011, aZLPO011p)13
The right procedure
̶ unconscious child, breathing after opening the airway
̶ call the ambulance
̶ keep the airway open, repetitively assess if the child is breathing
(look, listen and feel)
̶ if the child stops breathing → start CPR
immediately
První pomoc – přednáška (aVLPO011, aZLPO011p)14
Learning outcomes
̶ Student is able to describe steps of the algorithm of an approach
to the unconscious child.
̶ Student is able to explain the differences in the algorithm of an
approach to unconscious child and adult.
̶ Student is able to describe the procedure what to do with a child
who is unconscious and breathes normally.
První pomoc – přednáška (VLPO011, ZLPO011p)15
References:
̶ www.erc.edu
̶ Van de Voorde P, Turner NM, Djakow J et al. European Resuscitation Council Guidelines
2021: Paediatric Life Support. Resuscitation. 2021 Apr;161:327-387. doi:
10.1016/j.resuscitation.2021.02.015. Epub 2021 24th March.
̶ Madar J, Roehr CC, Ainsworth S, Ersdal H, Morley C, Rüdiger M, Skåre C, Szczapa T, Te
Pas A, Trevisanuto D, Urlesberger B, Wilkinson D, Wyllie JP. European Resuscitation
Council Guidelines 2021: Newborn resuscitation and support of transition of infants at birth.
Resuscitation. 2021 Apr;161:291-326. doi: 10.1016/j.resuscitation.2021.02.014. Epub 2021
Mar 24.
Simulation Centre, Faculty of Medicine, Masaryk University
2020