Life Support In Children Research Articles

Child Health Friendly School’ Capacity Building: Basic Live Support Training for Teachers

Most of the children spend a lot of their time at school. Therefore, school is an important place for program implementation or strategies that can be used to improve a child's health and well-being. Nevertheless, most teachers who worked at schools in the Wonogiri district including in Madrasah Ibtidaiyah Muhammadiyah Tawangharjo do not have sufficient knowledge and skills related to child’ health. For example, knowledge related to basic life support for emergencies at school is also still limited. Therefore, this community service aims to improve teacher capacity and awareness of children's health and well-being. The basic life support training was held online through Zoom meetings twice: in February and May 2023. Ten teachers from MIM Tawangharjo joined the training. All participants were very enthusiastic to follow the training. The pre-test showed that teachers' knowledge score on basic life support was still very limited, with an average score of 3.5 out of 10 total scores. After training, teachers' knowledge improved significantly. It was shown by the improvement of teachers' knowledge scores on the post-test with an average score of 9 out of 10 total score. There was almost a 70% increase in teachers' knowledge related to basic life support for children after training. The head of the school and teachers welcomed this community service activity and they hope that this training and collaboration can regularly be done to improve teachers and the school's capacity to be a child-health-friendly school

The Importance of Prolonged Pediatric Advanced Life Support in Children With Cold-Induced Traumas.

The Importance of Prolonged Pediatric Advanced Life Support in Children With Cold-Induced Traumas.

Withholding life support for children with severe neurological impairment: Prevalence and predictive factors prior to admission in the PICU

BackgroundOur study aimed to evaluate the prevalence and predictive factors of withholding life support for children suffering from severe neurological impairment before admission to the pediatric intensive care unit (PICU). MethodChildren under 18 years of age with severe neurological impairment, who were hospitalized between January 2006 and December 2016, were included in this retrospective study. They were allocated to a withholding group or a control group, depending on whether life support was withheld or not, before admission to the PICU. ResultsOverall, 119 patients were included. At admission to the PICU, the rate of withholding life support was 10 % (n = 12). Predictive factors were: (1) a previous stay in the PICU (n = 11; 92 %, p<0.01, odds ratio [OR]: 14 [2–635], p = 0.001); (2) the need for respiratory support (n = 5; 42 %, p = 0.01, OR: 6 [1–27], p = 0.01); (3) the need for feeding support (n = 10; 83 %, p = 0.01, OR: 10 [2–100], p = 0.001); and (4) a higher functional status score (FSS: 16 [12.5–19] vs. 10 [8–13], p<0.01). ConclusionThe withholding of life support for children suffering from severe neurological impairment appeared limited in our pediatric department. The main predictor was at least one admission to the PICU, which raised the question of the pediatrician's role in the decision to withhold life support.

Analysis of the Pediatric Radiotherapy Landscape in Mexico and a Subsequent Educational e-Contouring Intervention.

Mexico and Central America have the highest childhood cancer incidence in the West. Pediatric-specific oncology knowledge contributes to the disparity. We sought to (1) determine the self-identified treatment patterns and needs of Mexican pediatric radiation oncologists and (2) pilot a workshop to improve contouring accuracy. Partnering with local experts and the Sociedad Mexicana de Radioterapeutas (SOMERA), a 35-question survey was designed to ascertain pediatric radiotherapy capacity and distributed through the SOMERA listserv. The most challenging malignancies were selected for workshop. Participants received precontouring and postcontouring homework to assess improvement per the Dice metric. The Wilcoxon sign-rank test was used for comparative statistics. Ninety-four radiation oncologists attempted and 79 completed the survey. Forty-four (76%) felt comfortable treating a pediatric patient, and 36 (62%) were familiar with national protocols for pediatric treatment. Most had access to nutrition, rehabilitation, endocrinology, and anesthesia; 14% had access to fertility services and 27% to neurocognitive support; 11% noted no support, and only one respondent had child-life support. The postsurvey contouring workshop was conducted for high-grade glioma, medulloblastoma, and Hodgkin lymphoma. Significant improvements were seen in all target volumes. We present the first national survey of Mexico's pediatric radiotherapy capacity and Latin American e-contouring educational intervention with preworkshop and postworkshop Dice metrics, noting statistically significant improvement in all target volumes. Participation improved compared with prior experience through SOMERA partnership and Continuing Medical Education incentivization.

The Impact of Child Life Intervention on a Clinical Vaccine Trial

Needle-related procedures, such as vaccines, can be especially stressful for children. One children’s hospital secured funding to staff a child life specialist to provide support to patients enrolled in a vaccine trial. Data was collected to explore how participants coped through multiple nasal swabs, blood draws, and injections and the impact of providing child life support during a clinical research trial. Children supported by a child life specialist for their vaccine exhibited low distress and utilized coping strategies frequently. Participant retention was higher than expected during the clinical trial. The study findings suggest including child life specialists as part of clinical trial teams in future studies.

Cardiopulmonary resuscitation in pediatric patients under palliative home care - A multicenter retrospective study.

Introduction: Patients under palliative home care have special needs for their end-of-life support, which in general does not automatically include cardiopulmonary resuscitation. However, emergency medical services (EMS) respond to emergencies in children under palliative care that lead to cardiopulmonary resuscitation. To understand the underlying steps of decision-making, this retrospective, cross-sectional, multicenter study aimed to analyze pediatric patients under palliative home care who had been resuscitated. Methods: This study included patients from three spezialized pediatric palliative home care (SHPC) teams. The primary study parameters were the prevalence of cardiopulmonary resuscitation and the decision-making for carrying out pediatric advanced life support (PALS). Further analyses included the causes of cardiac arrest, the type of CPR (basic life support, advanced life support), the patient´s outcome, and involvement of the SHPC in the resuscitation. Descriptive statistical analysis was performed. Results: In total, 880 pediatric patients under palliative home care were included over 8.5 years, of which 17 patients were resuscitated once and two patients twice (overall, 19 events with CPR, 21.6 per 1,000 cases). In 10 of the 19 incidents (52.6%), cardiac arrest occurred suddenly without being predictable. The causes of cardiac arrest varied widely. PALS was performed in 78.9% of the cases by EMS teams. In 12 of 19 events (63.2%) resuscitation was performed on explicit wish of the parents. However, from a medical point of view, only four resuscitation attempts were reasonable. In total 7 of 17 (41.2%) patients survived cardiac arrest with a comparable quality of life. Discussion: Overall, resuscitation attempts were rare events in children under home palliative therapy, but if they occur, EMS are often the primary caregivers. Most resuscitation attempts occurred on explicit wish of the parents independently of the meaningfulness of the medical procedure. Despite the presence of a life-limiting disease, survival with a similar quality was achieved in one third of all resuscitated patients. This study indicates that EMS should be trained for advanced life support in children under home palliative therapy and SHPC should address the scenario of cardiac arrest also in early stages of palliative treatment. These results underline that advance care planning for these children is urgently needed.

Child Life-Facilitated Coping Support With Adult Patients Undergoing Cardiac Surgery: A Pilot Program

Purpose With little empirically known about the translation of child life services into adult patient populations, the purpose of this pilot project was to explore the feasibility of offering non-pharmacological child life support to adult cardiac surgery patients. Specifically, the aims were to explore the practical feasibility of extending and integrating child life care into this adult healthcare service, as well as the preliminary perceptions of adult patients who participated in the pilot program. Methods A pilot program was designed to provide child life care to an initial group of 11 adult patients undergoing cardiac surgery at a large academic medical center in the midwestern United States. Patients were randomized into a control condition consisting of standard pre- and post-cardiac surgery care or an intervention condition that involved five coping support interactions with a Certified Child Life Specialist serving as a “comfort coach.” Patient perceptions were gathered via telephone survey at the conclusion of the study, and insights into practical feasibility were gathered from associated study staff, clinical team members, and leadership to understand stakeholder experiences with the program. Results According to the feedback gathered, it appears that Certified Child Life Specialists can be clinically and practically integrated into adult cardiac surgery populations without patient care disruption. Additionally, feedback from program participants suggested that child life services were appreciated and seen as a beneficial component of the cardiac surgery experience. Conclusion This study suggests that it is both possible and practical to extend non-pharmacological coping support from Certified Child Life Specialists into adult cardiac surgery care, and this appears to be a desirable service from patient and staff perspectives. Future research is needed to evaluate the effects of child life services on specific outcomes in this population specific to anxiety, pain management and overall patient experience and care satisfaction.

Validity of Broselow tape for estimating the weight of children in pediatric emergency: A cross-sectional study.

ObjectiveTo assess the validity of the Broselow tape in estimating the weight of Chinese children in pediatric emergency.MethodsA cross-sectional study was conducted in the emergency department of the Children's Hospital of Zhejiang University School of Medicine (Hangzhou, Zhejiang Province, China) in March 2022. Broselow tape was used to estimate weight and its validity was compared with the advanced child life support (APLS) method.ResultsThe study included 442 children (mean age: 48 months; male-to-female ratio: 1.13:1). The < 10, 10–19 and > 19-kg groups included 44, 257, and 141 children, respectively. The color concordance rates of the Broselow tape-estimated weight in the three groups were 56.8, 57.2, and 68.1%, respectively. The percentage of weight estimations within 10% of actual weight were 65.8% (59.1, 65.8, and 68.1% for the <10, 10–19 and > 19-kg groups, respectively) and 44.8% (40.9, 50.6, and 35.5% for the < 10, 10–19 and > 19-kg groups, respectively) using the Broselow tape and the APLS method, respectively. The correlation between the Broselow tape estimated weight and actual weight was r = 0.931 (P < 0.0001, 95% CI: 0.918–0.943), while the correlation between actual weight and the APLS method calculated weight was r = 0.883 (P < 0.0001, 95% CI: 0.861–0.902). The mean percentage error using the Broselow tape was 1.0 ± 12.0% (P < 0.001 vs. −7.2 ± 17.2% of the APLS method).ConclusionThe Broselow tape may be an available method for predicting the weights of Chinese children in pediatric emergency.

Outcomes of Extracorporeal Life Support in Children with Meningococcal Septicemia: A Retrospective Cohort Study.

Meningococcal disease is associated with high mortality despite aggressive antibiotic therapy and intensive care support. Patients may develop refractory hypotension and acute respiratory distress syndrome in which extracorporeal membrane oxygenation (ECMO) could serve as a life-saving rescue therapy. However, there is limited data regarding the outcomes of ECMO support in the setting of meningococcal disease. This retrospective analysis of prospectively collected data from Extracorporeal Life Support Organization registry (1989-2019) enrolled children (29 days-18 years old) with Neisseria meningitidis infection receiving ECMO for any support type and mode. A total of 122 patients underwent a single course of ECMO support, equating to 122 ECMO runs. The overall survival-to-discharge rate was 46.7%. Patients receiving pulmonary venovenous (VV) ECMO had the highest survival-to-discharge of 85.7%, while those receiving venoarterial (VA) ECMO for pulmonary indications had a survival of 32.4%. Patients receiving VA ECMO support for cardiac indications had a survival-to-discharge rate of 60.9%. Those needing extracorporeal cardiopulmonary resuscitation (ECPR) had a poor survival (14.3%). Hemorrhagic complications were common, occurring in 43.4% of patients, but not found to be associated with mortality (complication was present in 47.7% of deceased and 38.6% of survivors, p = 0.31). Multivariable logistic regression analysis revealed that neurologic complications were associated with increased odds of mortality (odds ratio: 44.11; 95% confidence interval: 4.95-393.08). ECMO can be utilized as rescue therapy in children with refractory cardiopulmonary failure in setting of meningococcemia. Patients who require pulmonary VV or cardiac ECMO have the best ECMO outcomes. However, the use of ECMO in those suffering cardiac arrest (ECPR) should be undertaken with caution.

Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children.

BackgroundClinical differences between critical illness from influenza infection vs coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients.MethodsWe compared demographics, clinical characteristics, and outcomes of US children (aged 8 months to 17 years) admitted to the intensive care or high-acuity unit with influenza or COVID-19. Using mixed-effects models, we assessed the odds of death or requiring life support for influenza vs COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity.ResultsChildren with influenza (n = 179) were younger than those with COVID-19 (n = 381; median, 5.2 years vs 13.8 years), less likely to be non-Hispanic Black (14.5% vs 27.6%) or Hispanic (24.0% vs 36.2%), and less likely to have ≥1 underlying condition (66.4% vs 78.5%) or be obese (21.4% vs 42.2%), and a shorter hospital stay (median, 5 days vs 7 days). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life support in children with influenza vs COVID-19 were similar (adjusted odds ratio, 1.30; 95% confidence interval, .78–2.15; P = .32).ConclusionsDespite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19.

P072 Rhythm distribution over basic life support in children and adults cardiac arrest: Organized rhythm occurs more in Children

P072 Rhythm distribution over basic life support in children and adults cardiac arrest: Organized rhythm occurs more in Children

학령기 학부모를 위한 Bandura 부모효능감 척도 타당화 연구

The purpose of this study is to validate Bandura’s Parental Efficacy Scale for parents of elementary, middle, and high school students and to identify their parental efficacy level. The subjects of this study were 397 parents with elementary, middle and high school children, and data were collected online through standardized questionnaires through a survey institution. Through reliability and validity analysis, a parental efficacy scale of six factors(child life support, resilience, school system support, problem behavior prevention, school environment improvement, external environment support) was proposed. The reliability of the internal consistency of each sub-factor was .90-97. As for the parental efficacy of all parents, the effect of preventing problem behavior was the highest, and the sense of efficacy of school system support was the lowest. Parental efficacy sub-factors differed according to parental gender and child’s school level, and mothers showed higher efficacy in preventing problem behaviors and supporting external environments than fathers. Parents of high school children had a lower sense of efficacy for their children’s living support, school system support, and external environment support than parents of elementary and middle school children. Based on the research results, the use of scales and future research directions were discussed.

Candidacy for Extracorporeal Life Support in Children After Hematopoietic Cell Transplantation: A Position Paper From the Pediatric Acute Lung Injury and Sepsis Investigators Network's Hematopoietic Cell Transplant and Cancer Immunotherapy Subgroup.

The last decade has seen improved outcomes for children requiring extracorporeal life support as well as for children undergoing hematopoietic cell transplantation. Thus, given the historically poor survival of hematopoietic cell transplantation patients using extracorporeal life support, the Pediatric Acute Lung Injury and Sepsis Investigators' hematopoietic cell transplantation and cancer immunotherapy subgroup aimed to characterize the utility of extracorporeal life support in facilitating recovery from critical cardiorespiratory illnesses in pediatric hematopoietic cell transplantation patients. All available published data were identified using a set of PubMed search terms for pediatric extracorporeal life support and hematopoietic cell transplantation. All articles that provided original reports of pediatric hematopoietic cell transplantation patients who underwent extracorporeal life support were included. Sixty-four manuscripts met search criteria. Twenty-four were included as primary reports of pediatric hematopoietic cell transplantation patients who underwent extracorporeal life support (11 were single case reports, four single institution case series, two multi-institution case series, and seven registry reports from Extracorporeal Life Support Organization, Pediatric Heath Information System, and Virtual Pediatric Systems). All 24 articles were reviewed by first and last authors and a spread sheet was constructed including sample size, potential biases, and conclusions. Discussions regarding incorporation of available evidence into our clinical practice were held at biannual meetings, as well as through email and virtual meetings. An expert consensus was determined through these discussions and confirmed through a modified Delphi process. Extracorporeal life support in hematopoietic cell transplantation patients is being used with increasing frequency and potentially improving survival. The Pediatric Acute Lung Injury and Sepsis Investigators hematopoietic cell transplantation-cancer immunotherapy subgroup has developed a framework to guide physicians in decision-making surrounding extracorporeal life support candidacy in pediatric hematopoietic cell transplantation patients. In addition to standard extracorporeal life support considerations, candidacy in the hematopoietic cell transplantation population should consider the following six factors in order of consensus agreement: 1) patient comorbidities; 2) underlying disease necessitating hematopoietic cell transplantation; 3) hematopoietic cell transplantation toxicities, 4) family and patient desires for goals of care; 5) hematopoietic cell transplantation preparatory regimen; and 6) graft characteristics. Although risk assessment may be individualized, data are currently insufficient to clearly delineate ideal candidacy. Therefore, we urge the onco-critical care community to collaborate and capture data to provide better evidence to guide physicians' decision-making in the future.

Determining Pediatric Radiotherapy Capacity in Mexico

A 2019 report demonstrated that Mexico and Central America have the highest total incidence of childhood cancers in the Western Hemisphere. Mexican children face disparities in cancer outcome. In Mexico, the 5-year survival estimates for ependymoma and intracranial germ cell tumors, two pediatric brain tumor types, are approximately 20%, which is dramatically lower than the survival outcomes reported in the US of 80% or higher. We sought to determine the self-identified treatment patterns, needs, and concerns of Mexican radiation oncologists for pediatric cancer management.Stakeholder planning began the summer of 2019. Partnering with local experts and the national Sociedad Mexicana de Radioterapeutas (SOMERA), we reviewed and designed a Spanish-language survey to ascertain pediatric radiotherapy capacity. The survey consisted of 35 questions and was distributed through the SOMERA listserv with promotion on social media. The survey was open from July 11 through August 30, 2020. Descriptive statistics were conducted. For frequencies, we report median (range). Surveys were stored in Qualtrics.A total of 94 radiation oncologists attempted, and 79 completed, the survey and identified as working in Mexico, representing 20 different cities. Of those, 58 (73%) responded saying they had treated a pediatric patient within the past year with median 9 years of practice (1-38). Forty-four (76%) felt comfortable with treating a pediatric patient, and 36 (62%) said they were familiar with national protocols for pediatric cancer treatment. The median number of pediatric cases seen in the past year by respondents was 9.5 (0 - 195). The three most common tumors treated were Hodgkin lymphoma (2; 0-21), medulloblastoma (1.5; 0-20), and Wilms tumor (1; 0-20), respectively. The median percentage of pediatric patients treated palliatively was 10%. Also, 26% responded having access to a multidisciplinary tumor board. Regarding supports, the majority had access to nutrition, rehabilitation, endocrinology, and anesthesia; 14% had access to fertility services, 27% had access to neurocognitive support, 11% responded noting no support, and only 1 respondent had child-life support. When asked what challenges they face as physicians, 20% expressed a lack of treatment spots and extended delay to new start, and 16% noted challenges with access to pediatric oncology and multidisciplinary teams.We present the first national survey of Mexican radiation oncologists with an intent to explore pediatric radiotherapy capacity. Through partnership with SOMERA, many centers were represented across the country. The majority of respondents who had treated a child patient felt comfortable doing so. Limited resources include access to fertility, child-life, and neurocognitive services. Wait times and lack of treatment spots were the most common physician challenges identified by respondents.

Knowledge Level of Healthcare Professionals on Basic and Advanced Life Support in Children

Knowledge Level of Healthcare Professionals on Basic and Advanced Life Support in Children

The Use of Extracorporeal Life Support in Children With Immune-Mediated Diseases.

To describe the use and outcomes of extracorporeal membrane oxygenation support among children with immune-mediated conditions. Retrospective cohort study. The Extracorporeal Life Support Organization registry. Patients 1 month to 18 years old with International Classification of Diseases, 9th Edition and International Classification of Diseases, 10th Edition codes for immune-mediated conditions from 1989 to 2018. None. During the study period, 207 patients with an immune-mediated condition received extracorporeal membrane oxygenation, and 50% survived to discharge. Most patients (63%) received extracorporeal membrane oxygenation for respiratory support with 53% survival, 21% received cardiac support (55% survival), and 15% received extracorporeal cardiopulmonary resuscitation (34% survival). The most common diagnosis among nonsurvivors was hemophagocytic lymphohistiocytosis/macrophage activation syndrome with 37% survival. Patients with juvenile idiopathic arthritis (23%) and dermatomyositis (25%) had the lowest survival. Nonsurvivors had a higher frequency of infections, neurologic complications, and renal replacement therapy use. Use of preextracorporeal membrane oxygenation corticosteroids was associated with mortality. Children with immune-mediated conditions can be successfully supported with extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation use has increased over time, and survival varies considerably by diagnosis.

Resource Use During Pediatric Venipuncture With Virtual Reality: Secondary Analysis of a Randomized Controlled Pilot Trial.

Virtual reality (VR) therapy is growing in use and popularity during pediatric medical procedures. Currently, data that describe the hospital resources used during pediatric procedures with off-the-shelf VR games that are not tailored to medical procedures are lacking. In this study, we aimed to characterize procedural resources associated with VR use during venipuncture in a pediatric emergency department. This was a secondary analysis of a 2-arm randomized, controlled pilot trial with an external group. Resource use was evaluated in 3 groups: child life (CL)-supported VR engagement, CL support without VR, and a reference group that received no intervention (ie, no CL and no VR). The study sample (N = 55) included the following: 15 patients randomly assigned to VR, 20 patients randomly assigned to CL, and 20 patients in the reference group. There was a significant difference in procedure duration, with the VR group exhibiting the longest duration compared with the CL and reference groups (P = .01). Longer procedure times associated with VR use during venipunctures (4-6 minutes on average) may be attributed to pauses to troubleshoot VR games not tailored for medical procedures. Although they are inexpensive and accessible, nontailored VR games may warrant the need for dedicated staff to provide restraint and/or assistance to navigate the VR application. In this study, we offer a protocol on the application of nontailored VR games for pediatric procedures. For those considering a VR program in an inpatient setting, the benefits of pain/anxiety reduction must be weighed against the resources needed, including device costs, staff availability, and increased procedure duration.

INFLUENCE OF EMERGENCY MEDICAL STUDENTS TRAINING ON PREPAREDNESS TO PERFORM PAEDIATRIC LIFE SUPPORT

Aim: Assessment of the increase in knowledge in specific categories among students of the last-year emergency medical students after 45-hour training in advanced paediatric life support. Comparison of the impact of participation in the project and the ILS course on the increase of knowledge in the field of advanced life support in children. Material and methods: 138 third-year emergency medical students of the University of Rzeszów were studied. A proprietary questionnaire on paediatric life support was conducted before and after completing a 45-hour training on emergency medical services in children (pretest/posttest). Results: The mean percentage of subjects’ correct answers in the post-test was slightly over 60 which was statistically significantly higher compared to the pre-test, t(276)=6.54; p&lt;0.001. The highest percentage of correct answers concerned paediatric basic life support and AED (M=77.78; SD=12.47), while the lowest – cardiac arrest in children in special situations (M=60.54; SD=21.06). No statistically significant relationship was found between the percentage of correct answers in the pre-test/post-test and the respondents’ age, gender and participation in a competence development project (p&gt;0.05). Conclusions: The knowledge of paediatric life support among the third year emergency medical students is good. The students of subsequent years and individuals reading the literature and participating in the competence development project are better prepared to perform life support procedures in newborns and infants. From year to year, students gain less knowledge from medical literature and have the least knowledge on cardiac arrest in children in special circumstances.

Recommendation to reality: Closing the transcranial Doppler screening gap for children with sickle cell anemia

Although annual transcranial Doppler (TCD) screening is recommended for children with sickle cell anemia (SCA), compliance is low and variable. Our objective was to utilize an electronic health record (EHR)-based registry to improve TCD adherence among children with SCA, 2-16years of age, at our institution. We developed an in-EPIC real time registry for children with sickle cell disease in year 2016. Since end of year 2016, we have been extracting data quarterly to examine TCD rates and share the list of children who have not received a TCD screen in the past 18months with the clinical team. The registry also includes a TCD risk score to enhance point of care. We also added Child Life support to increase TCD compliance among children <7years. Control charts are used to examine TCD rates. At baseline, prior to and start of quarterly data audit and feedback, 63% of children received the recommended annual TCD screen. TCD rates steadily increased to 80% by the third quarter of 2017. We observed a dip in TCD rates, driven by failure of screening young children. Since the initiation of Child Life support for children <7years, we have sustained TCD screen rates >70%. Overall, our data meet criteria for special cause variation, indicating improvement in TCD rates since 2015. Regular tracking and identification of patients overdue for a TCD screen using an EHR-based registry resulted in sustained improvement in TCD screening rates. Involvement of Child Life support further improved TCD rates.

Basic life support for children and young people with a learning or physical disability and an altered body shape.

The number of people with complex health needs is increasing and this includes children and young people with a learning or physical disability. People with a learning or physical disability are at an increased risk of developing an altered body shape due to their lack of movement, which typically affects the chest. This has implications for healthcare professionals who may be required to provide basic life support (BLS) to such people. This article considers how the delivery of BLS for children and young people with a learning or physical disability and an altered body shape may need to be modified while still complying with the Resuscitation Council (UK) paediatric and adult BLS guidelines.