Cardiopulmonary resuscitation is an essential life-saving skill for parents to learn. CPR is given to save lives by restoring regular breathing and blood flow in case of life-threatening emergencies. When a person stops breathing and CPR is not performed immediately, they can die within minutes. When the incident occurs, the people closest to the victim can only perform CPR.
Why is Infant CPR An Essential Skill to Learn?
Cases of drowning, choking, suffocation, and other injuries can result in breathing difficulties. As a result, the child is at risk of suffering permanent brain damage and death with insufficient oxygen supply. The CPR process involves sets of compressions and rescue breathing. Chest compressions maintain blood circulation, while rescue breathing keeps blood flowing into the lungs.
CPR for infants is best performed by CPR-certified persons. CPR certification programs are available online for interested persons. Caregivers for children and infants should enroll in baby CPR courses. Online CPR certification is readily available, and the registration process is simple. There are no limitations on age and education for persons interested in taking the course. There is no excuse not to have CPR certification. Most importantly, with these skills, you could save the life of a loved one.
When is CPR Needed?
CPR is usually performed on unconscious persons, not breathing and without a pulse. Incidents that can result in breathing difficulties requiring CPR for small children include:
- Lung disease
- Head trauma and other serious injuries
- Excessive bleeding
- Electrical shock
- Drowning and choking
CPR Procedure for Children and Infants
Here's a step by step instruction on how to perform CPR on younger children and infants.
1. Check for consciousness
The first step in CPR for infants and children is checking if the victim is alert. Then, for younger children, you gently tap on the shoulder and ask, "Are you okay?" to see if they can talk or produce a sound. To elicit a response in infants, flick the bottom of their feet.
2. Call 911
If the child is not responsive, call 911 immediately. If you are alone, perform 2 minutes of CPR before leaving the child to call for help. The CPR process should start immediately, as every minute counts.
Quick CPR performance is the only way you can help the child survive, and a few minutes delays can worsen the situation. If anyone else is around, you should ask them to call for emergency medical services and bring the AED machine if available.
3. Begin CPR
Gently lay the child on a firm, flat surface. If you suspect the child of having a spinal or neck injury, two people can help move the child to avoid twisting the spine and head. While lying on their back, gently tilt the child's head backward and lift the chin. Listen for any signs of breathing or occasional gasps of air for not more than 10 seconds.
- Give rescue breathing only if the infant or child has a pulse but not breathing.
- If the infant or child doesn't have a pulse and not breathing, begin CPR starting with 30 chest compressions, followed by two rescue breaths.
- Kneel beside the child or infant. Place the heel of your hand on the chest right between the nipples.
- Place the other hand on top of the first, interlock the fingers, and then push hard.
- Press hard and fast on the chest at 2 inches deep, at a rate of 100-120 compressions per minute.
- Perform 30 compressions, then give two rescue breaths in that sequence.
- When giving CPR to infants, use two fingers and press on 1.5 inches giving 30 compressions and two rescue breaths.
- Open the airway by putting one hand on the child's forehead and two fingers on the chin. Tilt the head back to a neutral position.
- With the head tilted, gently pinch the child's nose and cover the mouth with your own, creating a proper seal. In this position, breathe into the child's mouth twice.
- For baby CPR, cover your mouth and nose with your mouth and blow in the air until the chest rises.
Keep giving 30 chest compressions and two rescue breaths until you see obvious signs of life, such as breathing or chest movement, specialized help arrives, the AED is available and ready for use, or you are too exhausted to keep going.
When the child starts breathing, put him in a recovery position and recheck the pulse and breathing while waiting for the emergency services team.
5. Use AED if available
The AED is a device used to restore the heart's rhythm in cases of ventricular fibrillation. The device has software that detects the heart's rhythm and indicates if an electrical shock could restore a regular heartbeat. If the heart is in a state of ventricular fibrillation, the device delivers a shock that restores it to its normal state.
During ventricular fibrillation, the heart is in chaos and unable to pump blood. It often results from a heart attack, affecting the ventricles or lower part of the heart. The condition leads to low blood pressure and insufficient oxygen supply to body organs. When these occur, the victim falls unconscious.
How to Use AED on Children and Infants?
The AED is safe for use in both children and infants. However, it would be best to use it as soon as possible to increase the chances of survival. With the AED, pediatric pads should be applied to children under eight. Use adult pads only when the pediatric ones are not available. Some pads are universal, with buttons to adjust the shock to the pediatrician (back and forth). For children under one year, always use a manual defibrillator if available.
Procedure for Using AED
- Prepare the AED and turn it on. Some AED devices have audio and visual prompts that guide users on their operation steps.
- Open or expose the child's or infant's chest. Check and remove any medication patches on the child with gloves, then wipe the chest dry.
- Peel off the backing on the pads. If necessary, connect the pads and plug in the connector.
- Before administering the AED, ensure everyone stays off the child, and no one is touching them by stating loudly, "stay clear." The rescuer should also stay clear of the victim.
- For older children, apply one pad on the upper right chest. The second pad goes to the lower left chest side. For infants, apply one pad on the upper left chest and the other on the back.
- Stay clear of the victim and let the device analyze the heart rhythm. It will give prompts that you should follow. If it indicates shock is necessary, press the shock button.
- Once the shock is delivered, resume CPR for another two minutes and deliver another shock.
- If the device doesn't indicate the need for a shock, continue CPR for two minutes or give five CPR cycles followed by the AED prompts. Continue with the sequence until you notice obvious signs of life in the victim.
- Discontinue CPR when the child or baby shows signs of life or starts breathing. Instead, keep the victim under close watch and note any changes in the condition.
How to Perform CPR During COVID-19 Pandemic?
Giving CPR is crucial as it could lead to exposure and transmission of illnesses. With the rising Corona infections, taking precautionary measures to protect yourself and others at home is good. Certain precautions apply, more so during the COVID-19 pandemic. You or the child you are attending could be infected with the virus.
The following precautionary measure needs to be effected when giving CPR.
- The rescuer should use personal protective equipment (PPE) such as masks and gloves.
- The victim's mouth should also be covered with a mask or a cloth to reduce transmission risk.
- Rescue breathing is a highly risky procedure and shouldn't apply. Instead, the victim should only be given chest compressions (hands-only CPR). Although chest compressions are not as effective as when accompanied by rescue breathing, it is proven to provide good results.
- When checking for life signs, the rescuer should look for visible signs (such as the victim's chest rising and falling) rather than listen or feel.
- If the cardiac arrest in the child or infant results from breathing difficulties caused by drug overdose, drowning or choking, the whole procedure involving rescue breathing and CPR is necessary. However, hands-only CPR is much better than not doing it at all. If the rescuer is uncomfortable giving mouth-to-mouth, they should continuously perform CPR until specialized help takes over the situation.
- It would be best if you used the AED, irrespective of whether the victim is COVID-positive. There is a minimum risk of infection when using the AED if the PPE is correctly used, as we saw above.
- After using the AED, clean it properly and disinfect it.
Knowledge of the performance of CPR on babies is critical. Cardiac arrest can occur anywhere, and it could happen at home. The chances of survival of the victim depend on the availability of a person skilled in CPR. At the discovery stage, children and infants expose themselves to risky situations. Parents should ensure that the people they entrust their children with are knowledgeable about CPR for babies. Older children should also be enrolled for babies.
CPR course programs and other first aid courses equip them with skills to handle emergencies. The rules surrounding the performance of CPR are continually changing with research and findings. If your certification is outdated, you will find it worthwhile to refresh your skills through CPR recertification programs, also available online.