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Cardiopulmonary Resuscitation for Infants

(Lay Rescuer CPR for Infants)

Definition

Cardiopulmonary resuscitation (CPR) is a series of steps to help a person who is not responding and has stopped breathing. CPR helps deliver oxygen rich blood to the body tissue when the body is not able to do this on its own. Infant CPR should be used in babies less than 12 months of age.

Infant Heart and Lung System

Infant CPR can keep blood flowing to vital organs until professional help arrives.

Reasons for Procedure

CPR is given when an infant has stopped breathing. Reasons for this may include:

The outcome will depend on the cause and how soon effective CPR was started. Many victims are unable to regain a normal heartbeat after it has stopped.

Possible Complications

It is possible that ribs may fracture or break during chest compressions.

Greater risk is involved if CPR is delayed or not done correctly.

What to Do

Prior to Procedure

Check for responsiveness. Tap the infant and ask loudly "Are you okay?" Call the infant's name if you know it. If the infant is unresponsive, follow these steps:

If someone is with you, have them call for medical help right away and get the automatic external defibrillator (AED). An AED is a device that delivers electric shocks to the victim's heart. If you are alone, do CPR for about two minutes before calling for medical help and the AED.
Check to see if the infant is not breathing or only gasping. If this is the case, begin CPR by giving chest compressions:
- $How to Administer CPR_Infant\chest compression infant cpr.jpg$
  Place two fingers on the center of the chest just below the nipple line.
- Compress about 1-½ inches in most infants. Push hard and fast at a rate of at least 100 compressions per minute.
- Allow the chest to rise completely between compressions.
- Minimize interruption between compressions.
- Give 30 compressions.
After 30 compressions, give two rescue breaths:
- $\How to Images\CPR\cpr_2a.jpg$
  Open the airway by gently tilting the head backward.
- $\How to Images\CPR\cpr_2b.jpg$
  Cover the infant's nose and mouth with your mouth.
- Breathe two puffs of air into his mouth and nose. Breathe just until you see the chest rise. Breaths should be about one second each.
If you are not trained in CPR, continue doing the chest compressions without giving rescue breaths.
If medical help has not been called, call after five cycles of CPR (about two minutes). Call even if the infant is responding and is breathing on his own.
Continue cycles of 30 compressions and two breaths until the AED is brought to you, medical personnel arrive, or the infant responds.
If another person is present, take turns doing the chest compressions to avoid getting tired. If two people are giving CPR, the ratio of chest compressions to breaths is 15 compressions and two breaths.
To use the AED:
- Turn the AED on.
- Attach the pads. Use the child-sized pads if available.
- Follow the prompts. If advised, deliver the shock. If the shock is not advised, the AED will tell you to resume CPR.

How Long Will It Take?

The length of time for CPR depends on the underlying causes and response time of medical help.

Will It Hurt the Infant?

The victim is unconscious when CPR is given. The procedure does not hurt. There may be some soreness in the chest after regaining consciousness.

Post-procedure Care

The emergency team will take over care when they arrive.

The victim will need to be taken to the hospital for evaluation following CPR.

Call For Help

If an infant is unresponsive and someone is with you, have them call for medical help right away. If you are alone, do CPR for about two minutes before calling for medical help.

RESOURCES:

American Heart Association
http://www.heart.org/

American Red Cross
http://www.redcross.org/

CANADIAN RESOURCES:

Caring for Kids
http://www.caringforkids.cps.ca/

Health Canada
http://www.hc-sc.gc.ca/

References:

American Heart Association. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science: Part 1 executive summary. American Heart Association website. Available at: http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S640 . Accessed November 16, 2012.

American Heart Association. Heartsaver First Aid with CPR and AED . Dallas, TX: American Heart Association; 2006

Berg MD, Schexnayder SM, Chameides L, et al. Part 13: Pediatric basic life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation . 2010; 122: S862-S875

Finer NN, Horbar JD, Carpenter JH. Cardiopulmonary resuscitation in the very low birth weight infant: the Vermont Oxford Network Experience. Pediatrics . 1999;104(3):428-434.

Otero L. What's new in neonatal resuscitation. Duval County Medical Society website. Available at http://www.dcmsonline.org/jax-medicine/2001journals/dec2001/resuscitation.htm . Published December 2001. Accessed November 16, 2012.

Topjian AA, Berg RA, Nadkarni VM.Pediatric cardiopulmonary resuscitation: advances in science, techniques, and outcomes. Pediatrics . 2008 Nov;122(5):1086-98. Review.

Last reviewed March 2013 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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