Core Concepts & Takeaways

• Apply ALS management skills during a pediatric cardiac arrest:
  • Airway management.
  • Vascular access. And,
• Investigate the unique causes of pediatric cardiac arrest.
• Demonstrate the current techniques of one- and two-rescuer CPR.
• Demonstrate the current techniques of pediatric cardiac arrest management.

An excerpt from the course Paramedic Recert EMS Care | 23-MCIT-F3-4108 | Pediatric Cardiac Arrest 

Ventricular Fibrillation is characterized by the rapid, uncoordinated quivering of the ventricles instead of the normal, forceful contraction. This motion is not synchronized with atrial contractions.  The heart does not pump blood, so pulses are not palpable.  A VT may precede a VF.

Only 5%-15% of pediatric cardiac arrests have VF as the initial rhythm, making it uncommon.  However, its prevalence could be higher as VF may occur early during an arrest before quickly deteriorating to asystole.

VF could occasionally occur in otherwise healthy teens during sports activities without previously known underlying causes.  The cause could be undiagnosed cardiac abnormality or channelopathy.   A sudden impact to the chest from a collision or a moving object may result in commotio cordis, leading to VF.  An arrest occurs when a nonpenetrating object, such as a baseball, hockey puck, or karate blow, strikes a child. The blow is most likely critical if it is over the center of the left ventricle. Because this results in VF and collapse, the presence of an AED is critical.

As always, consider the Hs and Ts for reversible causes.