Resuscitation update for the pediatrician.

Survival and neurologic outcome among pediatric patients in CPA have not improved measurably in the past decade, but the evolution of the pediatric Utstein guidelines has provided those involved in pediatric resuscitation a common language with which to exchange information and hopefully conduct meaningful research. The widespread use of the LMA may hold real promise for airway management of pediatric patients in the prehospital setting. Several of the developments in adult resuscitation, including ACD CPR and IAC CPR, seem auspicious for pediatric patients in cardiac arrest. At first glance, the widespread use of the AED would not be expected to alter the outcome of pediatric patients in CPA, but two studies suggest that ventricular fibrillation is more common in the pediatric population than originally believed, and thus the AED may have a significant role for this group of patients. The value of high-dose epinephrine remains controversial. All of these areas require research in the pediatric population before a judgment on their worth can be made. Research in pediatric resuscitation requires the study of larger populations, most feasibly with multicenter studies. How the "final rule" will influence this type of research remains to be seen. Finally, if investigators are to make real progress in improving the outcome of pediatric patients in CPA, they must concentrate their efforts on education of the lay public and enhancement of prehospital care.