# Paediatric Life-Threats: Emergency Clinical CPD Guide
> A JRCALC-aligned clinical guide for ambulance crews on managing paediatric respiratory failure, sepsis, and cardiac arrest in emergency pre-hospital care.

Tags: paramedic-cpd, paediatric-emergency, jrcalc, sepsis-recognition, cardiac-arrest, ambulance-service, clinical-skills
## Paediatric Life-Threats Overview
* **Audience:** UK Ambulance Service Clinical CPD (2026).
* **Core Philosophy:** Use 'Structural Confidence' and avoid mental mathematics by utilizing tools like the JRCALC App or Broselow Tape.

## Assessment & Human Factors
* **Crew Management:** Designate a lead, use closed-loop communications, and apply the 10-for-10 principle (10 seconds to plan 10 minutes).
* **A-E Approach:** Specific paediatric cues including neutral positioning for infants, checking posterior fontanelle tone (Disability), and the glass test for rashes (Exposure).

## Respiratory Management
* **Airway Anatomy:** Infants (<1yr) require a neutral position due to large occiput; children (>1yr) require the 'sniffing position'.
* **Escalation Path:** Position & O2 -> Treat cause (Nebs) -> Ventilate (BVM) -> Advanced (i-Gel/RSI alert).
* **Differentiation:** 
  * **Asthma:** Wheeze, PMHx. Rx: Salbutamol.
  * **Croup:** Barking cough, Stridor. Rx: Dexamethasone.
  * **Bronchiolitis:** Infants <2yr, wet cough. Rx: Supportive/Suction.

## Sepsis & Shock
* **Recognition:** The 'Paediatric 6' (Mottling, CRT >3s, HR abnormalities, Tachypnoea, Lethargy, Non-blanching rash).
* **The Golden Hour Action:** High flow O2, IO access if IV fails twice, and fluid boluses of 10-20ml/kg (checking JRCALC per kg).

## Paediatric Cardiac Arrest
* **Etiology:** 75% are caused by hypoxia/respiratory failure.
* **Protocol:** 15:2 compression/ventilation ratio. focus on early oxygenation. IO is the first-line access if IV fails.

## Conveyance & Pre-Alert
* **ATMIST Format:** Age, Time, Mechanism, Injuries, Signs, Treatment.
* **Hems/Critical Care Criteria:** GCS <8, ongoing seizure >20 mins, or post-ROSC care.
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