A 2 year old child is brought to your ED after being found submerged and unresponsive in a local home swimming pool. CPR is in progress, and there has been no return of spontaneous circulation.

a) List three reversible pathophysiological features of cardiac arrest that must be sought and corrected in this setting

[DDET Answer]





b) Outline four features of correct technique for external cardiac compressions in this child

[DDET Answer]

Delivery over lower half of sternum

Heel of hand or two handed technique used

Compression to 1/3 depth of chest

100 compressions/minute, minimising pauses associated with ventilation


c) You decide to immediately intubate this child. List at least six features of the airway that are physiologically different in a child compared to an adult

[DDET Answer]

Larger occiput influences optimal positioning of the child

Relatively larger tongue

Presence of relatively larger tonsils and adenoids in upper airway

Larger and floppier epiglottis

Larynx higher, more anterior, angled forwards

Narrowest part of airway at cricoid rather than glottis

Shorter trachea, requires care to avoid over-insertion of ETT



Additional resources / reading