The diagnosis of asystole is made in a pulseless patient on an ECG machine where the leads are correctly connected and the gain is fully turned up. This rhythm may be preceeded by an agonal bradycardia.
Asystole is the most common arrest rhythm in infancy and childhood and is usually the final common pathway of respiratory or circulatory failure.
Unlike adult resuscitation, defibrillation or a praecordial thump is not performed unless it is certain that ventricular fibrillation is occuring, as ventricular fibrillation is a rare and unusual rhythm in childhood.
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