CPR - child (1 to 8 yrs old) Health Article

Definition

CPR is a lifesaving procedure that is performed when a child's breathing or heartbeat has stopped, as in cases of drowning, suffocation, choking, or injuries. CPR is a combination of:

• Rescue breathing, which provides oxygen to a child's lungs.
• Chest compressions, which keep the child's blood circulating.

Permanent brain damage or death can occur within minutes if a child's blood flow stops. Therefore, you must continue these procedures until the child's heartbeat and breathing return, or trained medical help arrives.

Alternative Names

Rescue breathing and chest compressions - child; Resuscitation - cardiopulmonary - child; Cardiopulmonary resuscitation - child

Considerations

CPR can be lifesaving, but it is best performed by those who have been trained in an accredited CPR course. The procedures described here are not a substitute for CPR training.

All parents and those who take care of children should learn infant and child CPR if they haven't already. This jewel of knowledge is something no parent should be without. (See www.americanheart.org for classes near you.)

Time is very important when dealing with an unconscious child who is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur in as little as 4 to 6 minutes later.

Machines called automated external defibrillators (AEDs) can be found in many public places, and are available for home use. These machines have pads or paddles to place on the chest during a life-threatening emergency. They use computers to automatically check the heart rhythm and give a sudden shock if, and only if, that shock is needed to get the heart back into the right rhythm.

When using an AID, follow the instructions exactly.

Causes

In children, major reasons that heartbeat and breathing stop include drowning, suffocation, choking, head trauma or serious injury, excessive bleeding, electrical shock, poisoning, and lung disease.

Symptoms

• Unconsciousness
• No breathing
• No pulse

First Aid

The following steps are based on instructions from the American Heart Association.

1. Check for responsiveness. Shake or tap the child gently. See if the child moves or makes a noise. Shout, "Are you OK?"
2. If there is no response, shout for help. Send someone to call 911 and retrieve an AED (if available). Do not leave the child alone to call 911 and retrieve an AED until you have performed CPR for about 2 minutes.
3. Carefully place the child on their back. If there is a chance the child has a spinal injury, two people should move the child to prevent the head and neck from twisting.
4. Open the airway. Lift up the chin with one hand. At the same time, tilt the head by pushing down on the forehead with the other hand.
5. Look, listen, and feel for breathing. Place your ear close to the child's mouth and nose. Watch for chest movement. Feel for breath on your cheek.
6. If the child is not breathing:
   • Cover the child's mouth tightly with your mouth.
   • Pinch the nose closed.
   • Keep the chin lifted and head tilted.
   • Give 2 rescue breaths. Each breath should take about a second and make the chest rise.
7. Perform chest compressions:
   • Place the heel of one hand on the breastbone -- just below the nipples. Make sure your heel is not at the very end of the breastbone.
   • Keep your other hand on the child's forehead, keeping the head tilted back.
   • Press down on the child's chest so that it compresses about 1/3 to 1/2 the depth of the chest.
   • Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be FAST and hard with no pausing. Count the 30 compressions quickly: "1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off."
8. Give the child 2 more breaths. The chest should rise.
9. Continue CPR (30 chest compressions, followed by 2 breaths, then repeat) for about 2 minutes.
10. After about 2 minutes of CPR, if the child still does not have normal breathing, coughing, or any movement, leave the child if your are alone and call 911. If an AED for children is available, use it now.
11. Repeat step 9 until the child recovers or help arrives.

If the child starts breathing again, place them in the recovery position. Periodically re-check for breathing until help arrives.