Foreign Body Airway Obstruction

Foreign Body Airway Obstruction (FBAO) may cause mild or severe airway obstruction. When the airway obstruction is mild, the child can cough and make some sounds. When the airway obstruction is severe, the victim cannot cough or make any sound.
● If FBAO is mild, do not interfere. Allow the victim to clear the airway by coughing while you observe for signs of severe FBAO.
● If the FBAO is severe (ie, the victim is unable to make a sound):
— For a child, perform subdiaphragmatic abdominal thrusts (Heimlich maneuver) until the object is expelled or the victim becomes unresponsive. For an infant, deliver 5 back blows (slaps) followed by 5 chest thrusts repeatedly until the object is expelled or the victim becomes unresponsive. Abdominal thrusts are not recommended for infants because they may damage the relatively large and unprotected liver.
— If the victim becomes unresponsive, lay rescuers and healthcare providers should perform CPR but should look into the mouth before giving breaths. If you see a foreign body, remove it. Healthcare providers should not perform blind finger sweeps because they may push obstructing objects further into the pharynx and may damage the oropharynx. Healthcare providers should attempt to remove an object only if they can see it in the pharynx. Then rescuers should attempt ventilation and follow with chest compressions.

Drowning

Drowning is the second major cause of death from unintentional injury in children 5 years of age and the third major cause of death in adolescents. Most young children drown after falling into swimming pools while unsupervised; adolescents more commonly drown in lakes and rivers while swimming or boating. Drowning can be prevented by installing isolation fencing around swimming pools (gates should be self-closing and self-latching) and wearing personal flotation devices (life jackets) while in, around, or on water.

Sudden Infant Death Syndrome

SIDS is “the sudden death of an infant under 1 year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.”
The peak incidence of SIDs occurs in infants 2 to 4 months of age. The etiology of SIDS remains unknown, but risk factors include prone sleeping position, sleeping on a soft surface, and second-hand smoke. The incidence of SIDS has declined 40%40 since the “Back to Sleep” public education campaign was introduced in the United States in 1992. This campaign aims to educate parents about placing an infant on the back rather than the abdomen or side to sleep.

Firearm Injuries

The United States has the highest firearm-related injury rate
of any industrialized nation—more than twice that of any
other country. The highest number of deaths is in adolescents
and young adults, but firearm injuries are more likely to
be fatal in young children. The presence of a gun in the
home is associated with an increased likelihood of adolescent
and adult suicides or homicides. Although overall
firearm-related deaths declined from 1995 to 2002, firearm
homicide remains the leading cause of death among African-
American adolescents and young adults.

Burns

Approximately 80% of fire-related and burn-related deaths
result from house fires and smoke inhalation. Smoke
detectors are the most effective way to prevent deaths and
injuries; 70% of deaths occur in homes without functioning
smoke alarms.

Motor Vehicle Injuries

Motor vehicle–related injuries account for nearly half of all pediatric deaths in the United States. Contributing factors include failure to use proper passenger restraints, inexperienced adolescent drivers, and alcohol. Appropriate restraints include properly installed, rearfacing infant seats for infants 20 pounds (9 kg) and 1 year of age, child restraints for children 1 to 4 years of age, and booster seats with seat belts for children 4 to 7 years of age. The lifesaving benefit of air bags for older children and adults far outweighs their risk. Most pediatric air bag–related fatalities occur when children 12 years of age are in the vehicle’s front seat or are improperly restrained for their age.

For additional information consult the website of the National Highway Traffic Safety Administration (NHTSA): http://nhtsa.gov. Look for the Comprehensive Child Passenger Safety Information.
Adolescent drivers are responsible for a disproportionate number of motor vehicle–related injuries; the risk is highest in the first 2 years of driving. Driving with teen passengers and driving at night dramatically increase the risk. Additional risks include not wearing a seat belt, drinking and driving, speeding, and aggressive driving.

Bicycle Injuries

Bicycle crashes are responsible for approximately 200,000 injuries and nearly 150 deaths per year in children and adolescents. Head injuries are a major cause of bicycle related morbidity and mortality. It is estimated that bicycle helmets can reduce the severity of head injuries by >80%.

Pedestrian Injuries

Pedestrian injuries account for a third of motor vehicle related injuries. Adequate supervision of children in the street is important because injuries typically occur when a child darts out mid-block, dashes across intersections, or gets off a bus.

Pediatric Chain of Survival

For best survival and quality of life, pediatric basic life
support (BLS) should be part of a community effort that
includes prevention, basic CPR, prompt access to the emergency
medical services (EMS) system, and prompt pediatric
advanced life support (PALS). These 4 links form the
American Heart Association (AHA) pediatric Chain of Survival.
The first 3 links constitute pediatric BLS.
Rapid and effective bystander CPR is associated with
successful return of spontaneous circulation and neurologically
intact survival in children. The greatest impact occurs
in respiratory arrest, in which neurologically intact survival
rates of >70% are possible, and in ventricular fibrillation
(VF), in which survival rates of 30% have been documented.
But only 2% to 10% of all children who develop out-ofhospital
cardiac arrest survive, and most are neurologically
devastated. Part of the disparity is that bystander CPR is
provided for less than half of the victims of out-of-hospital
arrest. Some studies show that survival and neurologic
outcome can be improved with prompt CPR.

And here are the group of participants in the workshop held on February 10th., 2007.

American Heart Association : 2005 Guidelines for CPR and ECC

• About 75 percent to 80 percent of all sudden cardiac arrests happen at home, so being trained to perform cardiopulmonary resuscitation (CPR) can mean the difference between life and death for a loved one.
• Effective bystander CPR, provided immediately after sudden cardiac arrest, can double a victim’s chance of survival.
• CPR helps maintain vital blood flow to the heart and brain and increases the amount of time that an electric shock from a defibrillator can be effective.
• Approximately 95 percent of sudden cardiac arrest victims die before reaching the hospital.
• Death from sudden cardiac arrest is not inevitable. If more people knew CPR, more lives could be saved.
• Brain death starts to occur four to six minutes after someone experiences sudden cardiac arrest if no CPR or defibrillation occurs during that time.
• If bystander CPR is not provided, a sudden cardiac arrest victim’s chances of survival fall 7 percent to 10 percent for every minute of delay until defibrillation. Few attempts at resuscitation are successful if CPR and defibrillation are not provided within minutes of collapse.
• Coronary heart disease accounts for about 550,000 of the 927,000 adults who die as a result of cardiovascular disease.
• Approximately 335,000 of all annual adult coronary heart disease deaths in the U.S. are due to sudden cardiac arrest, suffered outside the hospital setting and in hospital emergency departments. About 900 Americans die every day due to sudden cardiac arrest.
• Sudden cardiac arrest is most often caused by an abnormal heart rhythm called ventricular fibrillation (VF). Cardiac arrest can also occur after the onset of a heart attack or as a result of electrocution or near-drowning.
• When sudden cardiac arrest occurs, the victim collapses, becomes unresponsive to gentle shaking, stops normal breathing and after two rescue breaths, still isn’t breathing normally, coughing or moving.