e-FIGURE 8.2 Rescue devices for airway management A: Laryngeal mask airway B: Esophageal Combitube (with close up) C: Laryngeal tube D: Perilaryngeal sealer (A: Reprinted with permission from Guimaraes E, Davis M, Kirsch JR, et al Anesthesia Technician and Technologist’s Manual 2nd ed Philadelphia, PA: Wolters Kluwer; 2019 B, C: Reprinted with permission from Barash PG, Cahalan MK, Cullen BF, et al Clinical Anesthesia 8th ed Philadelphia, PA: Lippincott Williams & Wilkins; 2018.) CHAPTER ■ CARDIOPULMONARY RESUSCITATION SAGE MYERS, DANA ARONSON SCHINASI, FRANCES M NADEL, SHANNON M GAINES GOALS OF EMERGENCY THERAPY Cardiopulmonary resuscitation (CPR) is a series of interventions aimed at restoring and supporting vital function after apparent death The immediate goal of resuscitation is to reestablish substrate delivery to meet the metabolic needs of the myocardium, brain, and other vital organs The overall goal is to return the child to society without morbidity related to the underlying disease or the resuscitation process Given the poor prognosis of children who develop cardiopulmonary arrest, primary prevention efforts are crucial in improving childhood mortality This chapter will focus on the management of the critically ill child and neonate based on the 2015 American Heart Association (AHA) CPR Resuscitation Guidelines, Pediatric Advanced Life Support (PALS) principles, the literature, and our experience INCIDENCE It is estimated that of the more than 6,000 children who suffer an out-of-hospital cardiac arrest (OHCA) annually, only 5% to 12% will survive, most with significant neurologic injury U.S mortality rates related to age in years for 2017 are shown in Table 9.1 There has been little improvement in pediatric OHCA outcomes over the past two decades Of note, mortality rates of children less than year old approach the rates of people over 54 years old Table 9.2 describes the leading causes of death for children and young adults After the first year of life, unintentional injury is the most common cause of death and therefore, preventable RELATED CHAPTERS Resuscitation and Stabilization A General Approach to the Ill or Injured Child: Chapter Airway: Chapter Shock: Chapter 10 Interfacility Transport and Stabilization: Chapter 11 Medical Emergencies Cardiac Emergencies: Chapter 86 Procedures and Appendices Prehospital Care: Chapter 134 The Children’s Hospital of Philadelphia Clinical Pathways ED Pathway for End-of-Life Care URL: https://www.chop.edu/clinical-pathway/end-of-life-care-clinicalpathway Authors: D Corwin, MD; E Friedlaender, MD, MPH; L Zinns, MD; T Kang, MD, MSCE; C Feudtner, MD, PhD, MPH; W Morrison, MD, MBE; J Hwang, MD, MHS; D Albert, RN, BSN, CPN, CPEN; W Frankenberger, RN, MSN, CCNS; B Rodio, RN, BSN, CEN, CPHQ Posted: October 2015, last revised May 2018 Clinical Pathway for Therapeutic Hypothermia Treatment for Neonates With Hypoxic Ischemic Encephalopathy (HIE) URL: https://www.chop.edu/clinical-pathway/therapeutic-hypothermiahypoxic-ischemic-encephalopathy-hie-clinical-pathway Authors : J Flibotte, MD; K Dysart, MD; J Stoller, MD; A Vossough, MD; L Billinghurst, MD; N Abend, MD; S Massey, MD; A Zanno, MD; N Pouppirt, MD; N Cook, MD; C Hufnal, MD; V Martin, MD; J Carroll, MSN; L Heimall, MSN; F Fung, MD; M Fitzgerald, MD; A Bustin, PharmD; H Monk Bodenstab, PharmD Posted: December 2018 Clinical Pathway for the Care of Children Post-CPR URL: https://www.chop.edu/clinical-pathway/cardiac-arrest-post-cprclinical-pathway Authors: A Topjian, MD; L Hutchins, MSN; P Meaney, MD; V Nadkarni, MD; R Berg, MD; J Blinder, MD; A Dewitt, MD; T Conlon, MD; J Fowler, MD Posted: August 2013, last revised December 2015, January 2018 PATIENT CHARACTERISTICS Age Children less than year of age have a much higher incidence and worse rate of survival from OHCA than older children or teens In large population-based studies of children who were resuscitated after an OHCA, over 60% were infants ... CARDIOPULMONARY RESUSCITATION SAGE MYERS, DANA ARONSON SCHINASI, FRANCES M NADEL, SHANNON M GAINES GOALS OF EMERGENCY THERAPY Cardiopulmonary resuscitation (CPR) is a series of interventions aimed at restoring... child and neonate based on the 2015 American Heart Association (AHA) CPR Resuscitation Guidelines, Pediatric Advanced Life Support (PALS) principles, the literature, and our experience INCIDENCE... rates related to age in years for 2017 are shown in Table 9.1 There has been little improvement in pediatric OHCA outcomes over the past two decades Of note, mortality rates of children less than