Infant or Child CPR

CPR stands for cardiopulmonary resuscitation. Infant/child CPR is an emergency lifesaving technique performed to keep oxygen and blood flowing through an infant or child’s body when their heartbeat and breathing have stopped.

The CPR procedure involves a combination of chest compressions, which move blood   from the heart throughout the body, and mouth-to-mouth breathing, which sends oxygen to the lungs to help revive or maintain circulatory flow and oxygenation.

Indications

Infant/child CPR is used to save the life of an infant or child suffering sudden cardiac arrest. This may be caused by incidents such as an obstructed airway, shock, or near-drowning.

Resuscitation protocols are different for infants and children. Infant guidelines apply to those under 1 year old, and child protocols are generally used from age 1 up to a weight of 121 lbs., or in the presence of signs of puberty (marked by axillary hair in males, and breasts in females). Adult resuscitation protocols apply to children past the age of puberty, or children weighing more than 121 lbs. Around 50 to 65% of children needing CPR are less than 1 year old, and of these, most are less than 6 months.

Procedure

CPR Procedure for Infant/Child

Here are some basic steps to follow if you find yourself in an emergency situation requiring CPR for an infant or child.

Step 1: Check for responsiveness.

Gently tap the infant or child’s shoulder or foot, and shout to get their attention. If they do not respond, move on to the next step and call 911 immediately, or tell someone else to call.

Step 2: Give 30 chest compressions.

Place the baby or child on their back on a flat, firm surface

• For a baby, kneel or stand to their side, with your hips at a slight angle
• For a child, kneel beside the child

For a baby, place both thumbs side-by-side at the center of the baby’s chest, just below the nipple line

• Use the other fingers to encircle the baby’s chest cavity toward their back, providing support underneath them
• Using both thumbs at the same time, push down hard and fast rhythmically
• Depress the chest 1to 1 ½ inches at a rate of 100 to 120 compressions per minute
• Allow the chest to return to its normal position after each compression

Alternatively, for a baby, you can use the two-finger technique:

• Use two fingers placed parallel to the chest in the centre of the chest

For a baby, if you cannot reach the depth of 1 ½ inches, consider using the one-hand technique

For a small child, use a one-handed CPR technique:

• Place the heel of one hand at the center of the child’s chest
• Push down hard and fast about 2 inches at a rate of 100 to 120 compressions per minute

For a larger child, place the heel of one hand at the center of the child’s chest, with your other hand on top, and your fingers interlaced and off the child’s chest.

• Position your shoulders directly over your hands and lock your elbows
• Keep your arms straight
• Push down hard and fast about 2 inches at a rate of 100 to 120 compressions per minute
• Allow the chest to return to its normal position after each compression

Step 3: Give 2 breaths

• For a baby, open their airway to a neutral position using the head-tilt/chin-lift technique
• For a child, open the airway to slightly past a neutral position using the head-tilt/chin-lift technique
• Seal your mouth over the baby or child’s lips and blow for about 1 second
• Ensure that each breath makes the chest rise
• Allow the air to exit before giving the next breath
• If the first breath does not cause the chest to rise, reposition their head and ensure a proper seal before giving a second breath. If the chest still does not rise, an object may be blocking the airway

Step 4:  Continue to give sets of 30 chest compressions and 2 breaths until:

• You observe an obvious sign of life
• An AED (automated external defibrillator) is available and ready to use
• Another trained responder is present to take over compressions
• EMS personnel arrive and begin their care
• You are alone and too tired to continue
• The scene becomes unsafe
• You have done approximately 2 minutes of CPR (5 sets of 30:2), you are alone and caring for the baby, and you need to call 911

Summary

CPR or cardiopulmonary resuscitation is a lifesaving action used in emergencies when someone is not breathing or their heart has stopped beating. CPR is something that everyone should know how to do - especially  parents and caregivers - since knowing CPR can save an infant’s or child’s life.