What are the key differences in the approach to paediatric resuscitation compared to adult resuscitation?

Key differences in paediatric resuscitation compared to adult resuscitation include:

• Initial approach: In newborns, resuscitation starts with providing air rather than immediate chest compressions or advanced airway interventions typical in adults. This reflects the primary issue often being respiratory rather than cardiac in origin in neonates ².
• Airway management: Suctioning of the upper airways before birth of the shoulders and trunk is avoided in babies, especially in the presence of meconium, unless the baby shows abnormal respiration, heart rate, or tone. This contrasts with adult resuscitation where airway clearance is a priority ².
• Monitoring and observation: Babies exposed to meconium but who are healthy require close observation in a specialised unit with access to neonatology, with specific timing for observations (1, 2 hours, then 2-hourly until 12 hours). Adults do not have such a protocolised observation period post-resuscitation ².
• Family involvement and support: During paediatric resuscitation, a team member is specifically allocated to communicate with and support the mother and birth companions, reflecting the importance of family-centred care in paediatrics ².
• Resuscitation decisions: For children and young people with life-limiting conditions, resuscitation is generally attempted unless a 'do not attempt resuscitation' order is in place, highlighting the ethical considerations unique to paediatric care ¹.

These differences reflect the physiological, developmental, and ethical distinctions between children (especially neonates) and adults in resuscitation scenarios.