Child with absent vital signs.

The outcome of cardiopulmonary resuscitation in the child with absent vital signs is dismal. Best outcomes therefore should rely on early recognition and aggressive management of critical illness to interrupt deterioration to cardiorespiratory arrest. Moreover, resuscitation entails a spectrum of care starting with cardiopulmonary resuscitation at the site of injury through critical care and post resuscitation rehabilitation. The resources required to provide this level of care is not available in many parts of the world. Therefore, resuscitation skills should be taught to caregivers at a level which is congruent to their role in the continuum of care and the use of aggressive resuscitation needs to be tailored based on geography, risk to medical personnel, preservation of resources, transplantation issues and expected outcomes. In some cases, the most prudent decision may be not to attempt resuscitation of the child with absent vital signs.