Wednesday , March 21 2018
Resuscitation CPR

Resuscitation Of A Child


Prolonged Hypoxemia due to inadequate oxygenation, ventilation and circulation and cardiac arrest/resuscitation.


Cardiac arrest and prolonged hypoxic children.


Cardio pulmonary resuscitation is a basic emergency procedure for life support, consisting of artificial respiration and manual external cardiac compressions.

Applicable Areas



Staff Nurse, Auxillary Nurse Midwife, NICU Registrar, Head Nurse and Consultants.


  • Keep the following equipments ready –
  • Ambu bag with face mask and oxygen connection.
  • Intubation tray containing small size endotracheal tube, laryngoscope with appropriate size blade, stellate, Dynaplast and lubrication jelly.
  • Crash Cart.
  • Ventilator with ventilator tubing.
  • Keep central suction ready with sterile suction catheter.
  • Two 100 ml Normal Saline for suction.
  • Radiant warmer, stethoscope.
  • Emergency drug like Inj. Adrenaline, Inj. Atropine, Inj. Soda-bi-carbonate.
  • Disinfectant for hand rubs.
  • Kidney tray.
  • Assess child for airway, breathing and circulation.
  • Establish airway by lifting the child’s chin or jaw should be displaced forward to maintain airway patency.
  • The neck should be extended slightly.
  • If airway is not patent intubation provides airway patency.
  • If respiratory arrest has occurred, ventilation must be provided using bag and mask with 100% oxygen.
  • A nasogastric tube should be introduced to relieve abdominal distension due to bag and mask ventilation.
  • The child should be well oxygenated before intubation.
  • Monitor heart rate throughout the procedure.
  • Bag and mask ventilation should be provided if the child becomes cyanotic or bradycardic.
  • Assist for intubation.
  • Once tube is passed, hand ventilation is performed while chest expansion is assessed and breath sounds are auscultated.
  • If clinical examination indicates satisfactory tube position, secure the tube with tape in such a way that the centimeter marking is visible at the child’s lips.
  • Attach Endo Tracheal Tube to mechanical ventilation.
  • Cardiac compression should be provided whenever cardiac arrest occurs.
  • The rescuer must compress the sternum directly over the heart.
  • Chest compressions are performed one finger width below the nipple line in the infant at the rate of 100/min. Compressions performed are finger width above the coastal sternal junction of a child at a rate of 100/min.
  • The child should be placed on a rigid cardiac board during compression.
  • Vascular access should be achieved quickly during CPR.
  • Same resuscitation drugs like adrenaline, atropine may be administered endotracheal.
  • Fluid or Blood products should be administered to the children who are in hypovolemic shock.
  • If spontaneous cardiac activity does not return within 30 minutes of resuscitation, it is reasonable for the team to consider cessation of resuscitation.
  • After the resuscitation, make the child comfortable.
  • Remove all the used articles, wash them and restock the crash cart.
  • Generated Biomedical waste should be segregated as per HIC policy.


  • Documents in Nurse’s Observation Sheet whether –
  • Resuscitation was successful.
  • Condition of a Child.
  • Duration of resuscitation.
  • The level of E.T. Tube should be recorded or an adhesive tape be placed at the head end of the bed.
  • The size and the marking of E.T. tube to be placed at the head end of the bed.
  • Observe for any hypothermia, acidosis or other complications.
  • Drugs used and the outcome.