BLS Choking Infant - Scenario 9 - Learn & Master ACLS/PALS

Comments

  1. Michele H. says

    HI Jeff! Thanks Again for a Great BLS Review! It really helps! I took ACLS & PALS for years and BLS was kind of pushed in.
    The first year I took BLS by itself surprised me!! and now more ACLS stuff is wrapped in. I have a question: Why is a Pulse Check
    done after Relief of Choking in Unresponsive Adult or Child pg 89 (also question on your test) and Not Done after Relief of Choking
    in Unresponsive Infant pg 90 (also on your test). I figure there must be a reason…Do you know?. Thanks Again!! Michele

    • ACLS says

      There are a few key reasons why a pulse check is typically done after relief of choking in an unresponsive adult or child, but not in an unresponsive infant:
      Difficulty in accurately detecting infant pulses:
      It can be very challenging to reliably detect a pulse in infants, even for trained healthcare providers. The brachial pulse in infants is small and can be difficult to locate and assess accurately. Due to this unreliability, pulse checks are generally not recommended as part of infant CPR protocols.

      1. Time considerations:
      2. Checking for a pulse takes valuable time. In infants, where rapid intervention is critical, guidelines recommend proceeding directly to CPR if the infant is unresponsive and not breathing normally, without taking time to check for a pulse. This allows life-saving interventions to begin more quickly.

      3. Different physiological responses:
      4. Infants tend to develop bradycardia (slow heart rate) more quickly than adults or older children in response to hypoxia. By the time an infant becomes unresponsive, they are likely to already be in cardiac arrest or very close to it. Therefore, starting CPR immediately is the priority.

      5. CPR guidelines:
      6. Current pediatric basic life support guidelines from organizations like the American Heart Association recommend starting chest compressions immediately for unresponsive infants who are not breathing normally, without a pulse check. This simplifies the algorithm and reduces delays to chest compressions.

      7. Risk vs. benefit:
      8. For adults and older children, a quick pulse check can help determine if the person is in cardiac arrest requiring CPR, or if they have restored circulation and only need rescue breathing. However, for infants, the risks of delaying CPR outweigh the potential benefits of a pulse check.

      Kind regards,
      Jeff

  2. ranjan basu says

    high pitched noise while inhaling or no noise at all is a sign of severe airway obstruction.
    wheezing between cough is a sign of mild airway obstruction

    • ACLS says

      The question was regarding “complete airway obstruction.” When the airway is completely obstructed, there will be no noise. Kind regards, Jeff

  3. Beth Kohler says

    Jeff,
    On page 74 under actions after choking relief it says if you have successfully removed an airway obstruction in an unresponsive victim to treat as you would any unresponsive victim. Check responsiveness, check for breathing & pulse, confirm ems was activated and provide high quality cpr or rescue breathing as needed. Shouldn’t we check for responsiveness first before doing more cpr?

    • ACLS says

      The BLS algorithm calls for CPR to continue until the patient becomes responsive or until emergency response arrives.

      Kind regards,
      Jeff

  4. Msrikureja says

    #5

    Should you not activate EMS at the start of “Back Slaps and Chest Thrusts”? You need the process of help to be initiated!

    • ACLS says

      In the AHA BLS algorithm, EMS is not activated until the infant becomes unresponsive. That is the how the official algorithm operates.

      That being said, I don’t think that it would be a problem to holler out for someone to activate EMS.

      I think the reason why EMS Is not activated first in the algorithm is that typically, foreign body airway obstruction is easily reversible when proper techniques are used.

      Kind regards,
      Jeff

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