Parents need to be aware of the steps involved in giving CPR as a first-aid measure when infants or babies suffer from breathing difficulty or cardiac arrest. The procedure involves chest compressions and rescue breaths. Since an infant’s bone density, strength, muscle arrangement, and physiology are different from that of an adult, the CPR procedure is different. The adult CPR procedure cannot be applied to babies as it can be harmful.
Read this post to know what CPR is and the steps involved in CPR in infants.
What Is CPR?
CPR or cardiopulmonary resuscitation is an emergency procedure to help a person not responding or who has stopped breathing. It helps deliver oxygen-rich blood to the body tissues and cells when the body cannot do so independently. Infant CPR can be performed in babies up to 12 months of age (1) (2).
- Chest compressions: Hard and fast pushes on the chest help in blood flow from the heart to the body.
- Rescue breaths: Mouth-to-mouth resuscitation/breathing helps deliver oxygen to the lungs.
Hence, until the medical help arrives or the baby returns to normalcy, CPR can help provide oxygen supply to the brain and other vital organs.
When Is CPR Given To An Infant?
Your baby may need CPR in the following scenarios:
- Not breathing or gasping for air
- Not responding to your touch
- Showing no movement
- Not waking up
- Not alert
- Any sudden, serious injury or shock to the body can affect the body’s functional ability. Trauma could result from a fall, animal attack, physical assault, or natural disasters.
- Choking: When food, toy, or other small object gets stuck in the airway, children may experience choking. Because of choking, air cannot flow in and out of the lungs properly, and children may have breathing difficulties.
- Near drowning or drowning could be a shock for the baby. And drowning may fill water up the lung, making breathing difficult.
- Electrical and lightning shocks could occur when an electric current passes through the body and damages the tissues, skin, and major organs, including the heart.
- Severe infection: Severe sepsis or septic shock can be some of the causes for the need of CPR among children.
- Severe allergic reactions, including anaphylaxis, can be life-threatening if not treated immediately. Such reactions may occur due to food (peanuts/nuts/seeds), food additives, insect bites, certain medicines, or vaccines.
What Is The CPR Ratio For An Infant?
One cycle of CPR for an infant comprises 30 compressions followed by two breaths.
In CPR for an infant, if there is one rescuer, the compressions-to-breaths ratio should be 30:2. It means after 30 compressions, they should open the airway and offer two breaths. In the case of two rescuers, one should perform chest compressions while the other should keep the airway open and perform ventilation at a ratio of 15:2 (7).
How Long Does It Take?
The length of CPR depends on the underlying problem or cause and the response time from the medical emergency team.
Complications Involved While Giving CPR
Although CPR is a life-saving procedure, it involves a greater risk if it is not carried out correctly or at the right time. In some cases, chest compressions can lead to breakage or fractures in the ribs (1).
What To Consider Before Starting CPR On The Baby?
Before starting CPR on the baby, look for the following (8):
- Check around for danger: Make sure there is no danger around you and the baby. Move the baby and yourself away from any such danger before performing the CPR.
- Check for response: Check if the baby responds by calling their name, and squeeze their shoulders.
- Seek help if the baby is unconscious: If the baby is not responding, breathing, or lying unconscious, then call for medical help immediately.
- Check baby’s mouth for airway blockages: Check for blockages in the baby’s mouth such as tongue, food, vomit, or blood. You can use the little finger to clear the airway after placing the baby on the back with the head in a neutral position.
- Check baby regularly for breathing and responses: Once the blockage is cleared, check for breathing, chest movements, breathing sounds, and breath (air) on your cheeks.
Steps To Perform CPR On Baby
Parents are encouraged to receive proper CPR training. The CPR on the baby includes the following steps (8):
- Lay the baby on a flat and firm surface.
- Don’t waste time trying to find a pulse. Place two fingers on the breastbone (center of the baby’s chest).
- Give the baby 30 fast chest compressions. Press hard so that the chest moves down by approximately 4cm or 1.5in.
- Count aloud and deliver about 100-120 chest compressions (two compressions per second) in one minute. See that the chest comes back to the original/initial position between these compressions. This step will ensure the blood reaches the vital organs.
- After you have delivered the first 30 compressions, place the palm on your baby’s forehead. Gently tilt the head back by placing two fingers on the chin’s bony part to open the airway.
- Next, place your mouth on the baby’s nose and mouth to seal the area and give two breaths. Make sure that each breath you give helps raise the baby’s chest and should not be more than one second in length. However, if the chest does not rise, move the position of the baby’s head, tightly seal the area, and then try giving rescue breaths again.
- During the two minutes, give cycles of 30 compressions and two rescue breaths. Repeat the cycle until medical help arrives or the baby regains consciousness or starts breathing. You can perform five cycles of 30 chest compressions and two breaths in two minutes.
- If the baby starts breathing again, they may have difficulty breathing or vomit after recovery. The process does not hurt the baby. However, they could have soreness in the chest. Put your baby in the recovery position that will keep the airway clear. In this position, the face should rest on the surface, and the chin should be away from the chest. Make sure there is no blockage or cover near your baby’s mouth and nose.
CPR is a life-saving procedure in infants when done correctly and without delay. It is, therefore, important to know the right steps to help your child in case of breathing difficulty or cardiac arrest. Otherwise, you may call medical help.
2. Cardiopulmonary Resuscitation (CPR) for Infants; Nationwide Children’s Hospital (2017)
3. Anaphylaxis; Beth Israel Lahey health Winchester Hospital
4. Trauma; Beth Israel Lahey health Winchester Hospital
5. Near-drowning; Beth Israel Lahey health Winchester Hospital
6. Electric burns and injuries; Beth Israel Lahey health Winchester Hospital.
7. Berg M. D.et al.; Part 13: pediatric basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care; American Heart Association
8. CPR for babies under 12 months: in pictures; Raising Children Network