Cardiac arrest
Children

In children, the most common cause of cardiac arrest is shock or respiratory failure that has not been treated. Cardiac arrhythmias are another possible cause. Arrhythmias such as asystole or bradycardia are more likely in children, in contrast to ventricular fibrillation or tachycardia as seen in adults.

Additional causes of sudden unexplained cardiac arrest in children include hypertrophic cardiomyopathy and coronary artery abnormalities. In childhood hypertrophic cardiomyopathy, previous adverse cardiac events, non-sustained ventricular tachycardia, syncope, and left ventricular hypertrophy have been shown to predict sudden cardiac death. Other causes can include drugs, such as cocaine and methamphetamine, or overdose of medications, such as antidepressants.

For management of pediatric cardiac arrest, CPR should be initiated if suspected. Guidelines provide algorithms for pediatric cardiac arrest management. Recommended medications during pediatric resuscitation include epinephrine, lidocaine, and amiodarone. However, the use of sodium bicarbonate or calcium is not recommended. The use of calcium in children has been associated with poor neurological function as well as decreased survival. Correct dosing of medications in children is dependent on weight, and to minimize time spent calculating medication doses, the use of a Broselow tape is recommended.

Rates of survival in children with cardiac arrest are 3 to 16% in North America.
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