Peds arrest is usually respiratory, not primary cardiac. Airway and oxygenation first.
Steps by Cert Level
EMT: High quality CPR: 100–120/min, 1/3 chest depth. 30:2 (1 rescuer) or 15:2 (2 rescuers). AED: peds pads if < 8 years / < 25kg. Ventilate with BVM — peds bag, correct mask size.
AEMT: IO or IV access. Epinephrine 0.01mg/kg IV/IO q3–5min.
PARAMEDIC: Identify and treat reversible causes (Hs and Ts). Advanced airway only if BVM inadequate — do not stop CPR. Amiodarone 5mg/kg IV/IO for refractory VF/pVT. Post-ROSC: avoid hyperoxia, target normothermia.