New PALS Guidelines Available

Community training centers around the country will be rolling out the new Pediatric Advanced Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Recently published as a special report in the November 2010 issue of Pediatrics, the new guidelines review advances in resuscitation science and best practice. Over the past 20 years, improved survival rates have been reported with in-hospital resuscitations for infants and children; however, survival rates to discharge with extramural cardiac arrests have remained at approximately 6%.

Respiratory events continue to be the primary etiology of cardiopulmonary arrests in children. Rapid response teams available to inpatient facilities with infants and children at increased risk for respiratory failure significantly decrease risk of arrest by early identification and intervention. Primary cardiac events, however, both in-patient and extramural events, continue to carry higher mortality. Manual defibrillators with pediatric-sized paddles and adjustable energy doses are preferred for use in children, particularly infants less than 12 months of age.

Family presence during resuscitation is becoming a more common occurrence. Studies report that these families identified benefits to and comfort from being present during resuscitation. The guidelines are careful to add that a staff member should be assigned to be with the family during the process to provide support and information as needed.

Online programs are available for Pediatric Advanced Life Support (PALS). Further information can be accessed on the American Heart Association Web site: www.americanheartassociation.org.

Dr. Mary E. Cataletto, FCCP
Steering Committee Member