Emergency Medicine

Paediatric Emergencies 343

CARDIOPULMONARY RESUSCITATION

(a) internal diameter of endotracheal tube (mm) = (age in

years/4) + 4

(b) oral endotracheal tube length uncuffed (cm) = (age in

years/2) + 12

(c) nasotracheal tube length uncuffed (cm) = (age in years/2)

+ 15.

3 External cardiac massage

(i) Check the circulation for no more than 10 s, by looking for signs

of life or palpate the carotid pulse (children) or femoral pulse

(children and infants).

(ii) Commence external cardiac massage if there are no signs of life:

(a) use two fingers in an infant over the lower half of the sternum

in the centre of the chest

(b) use a single hand in a child, to compress the chest by one

third of its depth

(c) perform compressions at a rate of at least 100/min, but not

exceeding 120/min.

4 Combine positive-pressure ventilation with chest compressions in the ratio

of 15:2 effective breaths.

(i) Use a ratio of 30:2 if a lone rescuer, particularly if untrained or if

cardiac compressions are inadequate.

Table 11.3 Paediatric endotracheal tube sizes

Endotracheal

tube (ET) size

(formulae)

Age (years)

Birth 4/12 1 3 7 10 12 14 16 Adult

Internal

diameter (mm):

age

4 + 4

Internal

diameter

(mm)

3.0 3.5 4.0 5.0 6.0 6.5 7.0 7.5 8.0 9.0

Oral length (cm):

age

2 + 12

Nasal length (cm):

age

2 + 15

Oral

length

(cm)

9 10 1213161718212223

Neonates:

3–3.5 mm

ET tube

(+ cuff)