Question

A child becomes unresponsive in the ED and is not breathing. You are uncertain if a faint pulse is present. You shout for help and provide ventilation with 100% oxygen. The rhythm shown here is seen on the cardiac monitor. What is your next action?

Answer 1

The next action when a child becomes unresponsive with no normal electrical cardiac activity is to start CPR and use an AED, if available, to restore normal heart rhythm and prevent brain damage.

Step-by-step explanation:

If a child in the Emergency Department (ED) becomes unresponsive and is not breathing with a rhythm on the cardiac monitor showing a total lack of normal electrical activity, your next action should include checking for the presence of a pulse and initiating CPR if the pulse is not definitely felt. Considering the situation is time-sensitive, with the risk of heart and brain damage, it is crucial to provide chest compressions and ventilation to support the circulation of blood and oxygen to the brain. The normal heart rhythm must be promptly restored to prevent prolonged oxygen deprivation.

Furthermore, the use of an Automated External Defibrillator (AED) is advised as soon as it is available, to analyze the rhythm and if appropriate, deliver a shock. CPR can be critical before the application of an AED, especially if there is a delay in AED arrival. Remember, in the absence of normal electrical activity and a definite pulse, you would expect the heart rate (pulse) to be absent, signifying cardiac arrest.