Pediatric patients who are bradycardic (a heart rate of less than 60 BPM) with signs of poor perfusion such as pallor, cyanosis, altered metal status or hypotension are at risk for imminent cardiac compromise. Most pediatric patients experience cardiac arrest secondary to hypoxia rather than cardiac disease pathologies. When a pediatric patient is experiencing bradycardia with signs of poor perfusion, the heart is unable to effectively distribute blood to the vital organs.

AHA guideline recommend starting compressions on a pediatric patient who is bradycardic despite adequate oxygenation. Early chest compressions in this patient population will help maintain blood flow to the brain and other vitals organs.

Remember, we are aiming for 100-120 compressions per minute with a depth of 1/3 of the chest.

When classifying a pediatric patient, we often describe them as a child 24 hours of age and greater to puberty. Puberty is defined as breast development in females and axillary hair in males. If the patient is showing signs of puberty, resuscitation is not required if the heart rate is less than 60 as they fit into the adult algorithm for CPR guidelines.

The CPR ratios for different patient populations are listed above.