PT  - JOURNAL ARTICLE
AU  - Deandra Luong
AU  - Po-Yin Cheung
AU  - Keith J Barrington
AU  - Peter G Davis
AU  - Jennifer Unrau
AU  - Shyamala Dakshinamurti
AU  - Georg M Schmölzer
TI  - Cardiac arrest with pulseless electrical activity rhythm in newborn infants: a case series
AID  - 10.1136/archdischild-2018-316087
DP  - 2019 Nov 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - F572--F574
VI  - 104
IP  - 6
4099  - http://fn.bmj.com/content/104/6/F572.short
4100  - http://fn.bmj.com/content/104/6/F572.full
SO  - Arch Dis Child Fetal Neonatal Ed2019 Nov 01; 104
AB  - The 2015 neonatal resuscitation guidelines added ECG to assess an infant’s heart rate when determining the need for resuscitation at birth. However, a recent case report raised concerns about this technique in the delivery room. We report four cases of pulseless electrical activity during neonatal cardiopulmonary resuscitation in levels II–III neonatal intensive care units in Canada (Edmonton [n=3] and Winnipeg [n=1]).Healthcare providers should be aware that pulseless electrical activity can occur in newborn infants during cardiopulmonary resuscitation. We propose an adapted neonatal resuscitation algorithm to include pulseless electrical activity. Furthermore, in compromised newborns, heart rate should be assessed using a combination of methods/techniques to ensure accurate heart rate assessment. When ECG displays a heart rate but the infant is unresponsive, pulseless electrical activity should be suspected and chest compression should be started.