A 9 year old child has suddenly collapsed. After confirming that the scene is safe, a single rescuer determines that the child is in cardiac arrest, shouts for nearby help, and activates the emergency response system by using his mobile device. He immediately begins performing high-quality CPR. Two additional rescuers immediately arrive to assist in the resuscitation attempt. What actions should occur next to support a team-based resuscitation attempt? a. Two rescuers should alternate using the AED and giving breaths b. Two rescuers should alternate giving high-quality chest compressions c. Two rescuers should operate the AED while the third rescuer gives breaths d. One rescuer should give CPR while the other two wait for advanced life support to arrive
The Correct Answer and Explanation is:
Correct Answer: b. Two rescuers should alternate giving high-quality chest compressions
Explanation:
In a pediatric cardiac arrest scenario, especially when multiple rescuers are present, coordinated and efficient team-based resuscitation significantly improves the chance of survival. Once high-quality CPR has been initiated and emergency services have been activated, the arrival of additional rescuers enables an enhanced and more effective response.
Why Option B is Correct:
High-quality chest compressions are the cornerstone of successful resuscitation. The American Heart Association (AHA) recommends that chest compressions should be performed at a rate of 100–120 per minute and a depth of at least one-third the anterior-posterior diameter of the chest (about 2 inches for children). Because compressions are physically demanding, rescuer fatigue can rapidly compromise compression quality. To maintain effective compressions, two rescuers should alternate providing compressions every 2 minutes, ideally switching roles with minimal interruption to CPR.
While one rescuer performs compressions, the other can be responsible for providing rescue breaths using a bag-valve mask (BVM) if trained, or preparing the automated external defibrillator (AED) and attaching it to the child.
Why the Other Options Are Incorrect:
- Option A: Alternating AED use and breathing is not practical. The AED requires limited operation once it is attached. Breath delivery should be coordinated with compressions, not alternated with AED use.
- Option C: Only one rescuer is needed to operate the AED. It is inefficient to assign two people to the AED while neglecting chest compressions.
- Option D: It is inappropriate for two rescuers to simply wait. All team members should contribute actively—by performing compressions, ventilating, or managing the AED—until advanced life support arrives.
Summary: Team-based CPR should maximize efficiency, minimize interruptions, and rotate tasks to maintain high-quality resuscitation efforts, with alternating chest compressions being a key component.
