Resuscitation reference table

Summary of changes

This table has been substantially changed from the 2017 version by the primary reviewers. Updates to this table for paediatric recommendations are based on the Royal Children’s Hospital (RCH) Melbourne guideline “acceptable ranges for physiological variables” and resuscitation guidelines. 

Addition

  • Values for defibrillator from Term to 6 months of age
  • Maintenance rates added with addition that most unwell children should receive 2/3 maintenance rates and small correction made to reflect current RCH guideline formula
  • O2 sats included in table

Deletion

  • Endotracheal tube (ETT) size has been deleted as ETTs are not routinely included in the resuscitation equipment of remote clinics and this practice is outside of remote clinicians (ETTs are carried by Retrievalists with specialist training in advanced airway management)
  • Cuff volumes for LMAs have not been included. Remote clinics usually carry i-Gel LMAs which do not have an inflation port for the cuff

Medicines

  • Paediatric doses of Adrenaline (cardiac arrest), Amiodarone and Atropine have been adjusted to reflect the RCH guidelines of accepted physiological parameters
  • Paediatric glucose dose corrected to 2mLs/kg per RCH guidelines. Use of 50% glucose has been removed - it is only used with medical consultation for severe hypoglycaemia or hypokalaemia
  • Column added for Midazolam intranasal (i.n) or buccal for seizures without IV access. Midazolam IV/IO - dose changed to 0.15mg/kg as per children's Australian Medicines Handbook and RCH guidelines
  • Doses for  adults 70kg+ have been standardised to assist in avoiding potential cumulative errors with repeated doses
  • Standardisation of all doses to volumes (previously mix of volumes and strengths)

Other

  • Age:weight based recommendations have been updated to reflect the RCH guidelines of accepted physiological parameters
  • Greater emphasis placed on titrating oxygen administration to SpO2 ≥ 94% with less emphasis on flow rates

Primary references

  1. Australian Resuscitation Council (2016) ANZCOR Guideline 11.5 – Medications in Adult Cardiac Arrest, The ARC Guidelines, accessed 11 January 2022.

  2. Australian and New Zealand Committee on Resuscitation (2018) ANZCOR Guideline 11.2 – Protocols for Adult Advanced Life Support, The ARC Guidelines, accessed 11 January 2022.

  3. Australian and New Zealand Committee on Resuscitation (2016) ANZCOR Guideline 12.5 – Management of Specific Dysrhythmias in Paediatric Advanced Life Support, The ARC Guidelines, accessed 11 January 2022.

  4. King BR (2021) Emergency rescue devices for difficult pediatric airway management, UpToDate, accessed 11 January 2022.

  5. The Royal Children's Hospital Melbourne (2020) Acceptable ranges for physiological variables, Clinical Practice Guidelines, accessed 16 September 2022.

  6. The Royal Children's Hospital Melbourne (2020) Afebrile seizures, Clinical Practice Guidelines, accessed 17 September 2022.

  7. The Royal Children's Hospital Melbourne (2021) Anaphylaxis, Clinical Practice Guidelines, accessed 17 September 2022.

  8. The Royal Children's Hospital Melbourne (2020) Intravenous fluids, Clinical Practice Guidelines, accessed 17 September 2022.

  9. The Royal Children's Hospital Melbourne (2017) Oxygen delivery, Clinical Practice Guidelines, accessed 17 September 2022.

  10. The Royal Children's Hospital Melbourne (2021) Emergency drug doses, Clinical Practice Guidelines, accessed 17 September 2022.