Mercier J C
Service de réanimation pédiatrique, hôpital Robert-Debré, Paris.
Rev Prat. 1990 Mar 21;40(9):797-806.
Cardiac arrest in infants and children is usually not unexpected. All efforts, therefore, should be made to recognize a high risk situation soon enough and to apply the emergency therapeutic measures that are mandatory. When the drama occurs, cardiopulmonary resuscitation (CPR) must be instituted at once according to a well-defined sequence: first, elementary CPR performed by any occasional rescuer, including 1. clearing of the airways, 2. mouth-to-mouth breathing, and 3. closed cardiac massage (CCM); then, medical CPR applied by a professional rescuer pursuing the same objectives and consisting of 1. tracheal intubation, 2. manual or mechanical ventilation with pure oxygen, 3. controlled efficacy CCM, and 4. intratracheal, then intravenous or intraosseous injection of adrenaline. As this sequence cannot be improvised, no effort should be spared to teach and organize CPR outside and within hospitals.