Cardiac arrest in children and infants involves the sudden cessation of the heart’s mechanical activity, leading to a lack of blood flow to the brain and other vital organs. This condition is uncommon in pediatric populations. Despite its rarity, pediatric cardiac arrest represents a severe and life-threatening emergency that demands immediate attention. Understanding its common causes is important for effective prevention and response.
Primary Causes in Children and Infants
In children and infants, cardiac arrest often develops as a secondary event, resulting from respiratory failure or circulatory shock. Respiratory issues are a predominant factor, with conditions such as severe asthma attacks, pneumonia, or other lung infections leading to oxygen deprivation. Airway obstruction from choking on foreign objects or aspiration of substances can also quickly lead to respiratory compromise and subsequent cardiac arrest.
Circulatory problems, especially shock, also commonly precede cardiac arrest in this age group. Severe dehydration, often from prolonged vomiting or diarrhea, can lead to hypovolemic shock, where the body lacks sufficient fluid volume to circulate blood. Sepsis, a severe response to infection, can cause widespread inflammation and circulatory collapse. Significant blood loss due to trauma also reduces circulating blood volume, leading to shock and cardiac arrest.
Trauma is another direct cause of cardiac arrest. Accidental injuries like falls or car accidents can result in internal bleeding or direct impact to the chest, disrupting heart function. Non-accidental trauma, such as abusive head trauma, can cause severe brain injury that affects vital bodily functions, including breathing and circulation.
Accidental poisoning or overdose can depress the central nervous system and respiratory drive, leading to cardiac arrest. Sudden Infant Death Syndrome (SIDS) is also linked to cardiac arrest. While less common as a primary cause, underlying congenital heart conditions can contribute to cardiac arrest in children with diagnosed heart disease.
Key Differences from Adult Cardiac Arrest
A fundamental distinction exists in the origin of cardiac arrest between children and adults. In adults, cardiac arrest is most often a primary cardiac event, frequently caused by issues like coronary artery disease or a heart attack.
In contrast, pediatric cardiac arrest is more commonly a secondary event. It stems from a deterioration of other bodily systems, primarily respiratory failure or circulatory shock. The heart stops beating because it is deprived of oxygen or sufficient blood volume, rather than from a primary electrical or structural problem.
Recognizing Signs and Taking Immediate Action
Recognizing the signs of cardiac arrest in children and infants is important for immediate action. A child in cardiac arrest will be unresponsive. They will also exhibit an absence of normal breathing, which may appear as gasping or only occasional, ineffective breaths. If trained to check for a pulse, there will be no detectable pulse or a very slow pulse below 60 beats per minute with signs of poor perfusion.
Immediate action is important in these situations. The first step is to call emergency services to alert medical responders. While awaiting their arrival, initiating cardiopulmonary resuscitation (CPR) is essential. CPR involves performing chest compressions at a rate of 100 to 120 compressions per minute and providing rescue breaths, which helps maintain blood circulation and oxygenation to vital organs. Learning CPR is an important skill for parents and caregivers, as early intervention significantly improves survival rates.
Strategies for Prevention
Implementing prevention strategies can significantly reduce the risk of cardiac arrest in children and infants. For infants, adhering to safe sleep practices, such as placing them on their back for sleep on a firm mattress without loose bedding, helps reduce the risk of SIDS. Preventing choking is also important, which involves offering age-appropriate foods cut into small pieces and keeping small objects out of reach of young children.
Injury prevention measures are also important, including consistent use of appropriate car seats and childproofing homes by securing dangerous items and supervising children around water. Safely storing medications and household chemicals out of sight and reach is an important strategy to prevent accidental poisoning. Prompt medical attention for severe infections, respiratory illnesses, or known congenital heart conditions is also important to manage underlying health issues.