Diagnostic Approach

Assessing respiratory status:

• Inspection: retractions, nasal flaring, accessory muscle use
• Auscultation: decreased breath sounds, wheezing, rales, rhonchi
• Pulse oximetry: monitors oxygenation
• Capnography (ETCO2): monitors ventilation
• Blood gas analysis: evaluates oxygenation, ventilation, and acid-base status

Assessing circulatory status:

• Heart rate and rhythm
• Blood pressure: hypotension indicates shock (systolic BP <5th percentile for age)
• Capillary refill time
• Skin temperature, color
• Mottling
• Weak peripheral pulses
• Altered mental status

Identifying arrest rhythm:

• Asystole – flatline on ECG
• Pulseless electrical activity (PEA) – organized electrical activity without pulses
• Bradycardia – slow heart rate
• Tachycardia – rapid heart rate
• Ventricular fibrillation (VF) – chaotic ventricular activity
• Pulseless ventricular tachycardia (pVT) – wide complex rhythm without pulses