How to Perform CPR on a Child or Infant
There are some very important guidelines to follow when performing CPR on children and infants that all of us should memorize. Better yet, taking a class and getting certified in CPR for children, and adults, can be one of the best skills that anyone can learn. However, knowing what to do if you were ever faced with such a situation is so important that we’re going to outline the general steps here.
Assessing the Patient
The first step when encountering an unconscious child or infant is to check for breathing or a pulse. Place the patient on their back on a hard surface. Gently tilt the head and neck back slightly to open the airway. Check for breaths or if the chest is rising or falling.
To check the pulse of a child, feel the carotid artery alongside and between the windpipe and neck, just as you would with an adult. To check the pulse of an infant-toddler, it’s often easier to feel for it in the top of the underarm, where the arm joins to the shoulder. Never perform CPR if you feel a pulse.
Always check the patient’s airway before performing CPR. Most cases of pediatric cardiac arrest occur due to choking or airway blockage. Children and infants have smaller airways than adults, and it’s very easy for them to swallow and choke on all sorts of items that they put in their mouths. If the airway is obstructed, follow pediatric choking guidelines for more information.
If the airway is not obstructed, there is no breathing, and the patient has no pulse, then start CPR. If there is a pulse but no breathing, provide two quick breaths by covering your mouth over the mouth and nose of infants and mouth of bigger children while pinching their nose closed. Check for breathing. If no breathing, provide one breath, in a one second burst, every five seconds. Remember that infants and children have fragile respiratory systems. You only want to exhale with just enough force to cause their chest to rise and fall as though they were breathing normally.
Keep breathing until they either start breathing on their own, paramedics take over, or the patient arrives at a hospital.
If the patient has no pulse and is not breathing, immediately administer 30 chest compressions at a rate of 100 beats per minute. For infants, use your index and middle finger to administer the compressions, and press down to a depth of about 1/3 the height of their torso when looking at them from the side. For children, use normal, two handed CPR and compress to about the same depth. Remember that children have more flexible bones than adults, so they can bend more easily and resist fracturing.
Don’t be afraid to be aggressive with your compressions. However, you need to use restraint at the same time due to their fragility and small size. Unfortunately, the only real way to get an understanding and feel for this is through training or by experience. If you’re ever in this situation, just use your best judgment until someone more proficient can intervene.
After your initial 30 compressions, check for a pulse and continue CPR if necessary. Give two more rescue breaths before an additional 30 compressions. Do this for a couple of cycles before calling 911 in order to provide oxygen and circulation to the patient. Continue CPR until help arrives by repeating the cycle and checking the pulse.
Remember that any one of us can encounter a life-threatening pediatric emergency at any time, and our intervention can make a difference. While almost anyone can “guess” their way through CPR on adults, children need a lot more care and attention. Learn more about rendering aid to pediatric patients, and consider getting some formal training. You never know when you will be thrust into a situation where you have to put those skills to use. One thing’s for sure: You will be glad that you were prepared if and when that time comes.