By United Medical Education
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This article has CPR techniques for an infant (age 0 to 1) in an essay format. For abbreviated instructions that include bullet points please build a free user account and login to view our free course study materials.
This article will present a series of techniques commonly used to assess and treat infants in respiratory and cardiac distress. Four steps should be followed. These steps are circulation, airway, breathing, and defibrillation (CABD). The Infant CABD survey steps have certain changes compared to that of the adult.
In this scenario you find an infant lying on the floor.
First, assess to see if the infant is responsive to stimuli by lightly tapping the infant’s foot and lightly shaking the infant. If you are alone and you witnessed the collapse of the infant then call 911 immediately. If you are alone and you do not witness the collapse then perform two minutes of CPR and then call 911. Place the infant on a hard flat surface.
Next, feel for a brachial or femoral pulse for five to ten seconds.
If the infant has a pulse then move to the airway and breathing portions of the CABD survey, checking the infant for a pulse every two minutes. If the infant does not have a pulse begin five cycles of CPR. Start by performing chest compressions. Chest compressions are performed at a rate of 100 compressions a minute. Place two fingers one centimeter below the infant’s nipple line. Perform chest compressions to a depth of 1/3 to 1/2 the depth of the infant’s chest. Compressions should be performed hard and fast allowing for full chest recoil. Avoid interruptions to the chest compressions. One cycle of CPR is thirty chest compressions to two rescue breaths. If two people are providing CPR switch rolls between the person giving chest compressions and the person giving rescue breaths every five cycles of CPR.
A patent airway must be secured to successfully perform rescue breaths. If the collapse was not witnessed, involved drowning, or involved trauma the jaw thrust maneuver should be used. To perform the jaw thrust maneuver effectively place your fingers on the lower rami of the jaw. Then provide anterior pressure advancing the jaw forward. If the collapse was witnessed and no cervical spine injury is assumed then a head tilt chin lift maneuver is an appropriate technique to open the airway. To perform the head tilt chin lift maneuver place your palm on the infant’s forehead and apply gentle pressure to tilt the head back. Then place the fingers of your other hand under the infant’s mental protuberance and lift the chin forward and cephalic.
The infant needs to be assessed for normal breathing. This includes chest rise and or hearing and feeling air movement. If the infant is adequately breathing you should continue to assess and maintain a patent airway. If the infant is not adequately breathing than rescue breaths should be provided. Start by giving the patient two rescue breaths. To perform rescue breaths on the infant start by using your mouth to make a seal over the mouth and nose of the infant. Each rescue breath should be approximately one second in length. During the rescue breath watch for chest rise. Assure sufficient time is allowed for the air to expel from the infant’s lungs. During normal CPR without an advanced airway, approximately six rescue breaths should be performed a minute. If the infant does have an advanced airway and CPR is being performed then eight to ten rescue breaths should be performed in a minute. If the infant has a pulse and CPR is not required but the infant still required rescue breaths, perform ten to twelve rescue breaths per minute. Remember to continue rechecking the infant for a pulse every two minutes.
When the AED (Automated External Defibrillator) arrives begin using it immediately. Early defibrillation is the single most important therapy with regards to cardiac arrest. The AED should provide you with simple and easy to follow verbal prompts. To attach the AED place the appropriately sized shock pads on the patient’s skin. The shock pads should have images on them to indicate their appropriate placement. The AED will then require a short pause in CPR to analyze the heart rhythm of the infant. If the AED discovers that the infant’s heart rhythm is not shockable initiate five cycles of CPR. Have the AED recheck the infant’s heart rhythm at the end of the five cycles of CPR. If the AED discovers that the heart rhythm is shockable assure no one is touching the infant or in mutual contact with a conductor of electricity. You can do this by yelling “Clear!” before delivering a shock from the AED. Press the shock button on the AED after all providers are clear of the infant. After shocking the infant begin 5 cycles of CPR.
CPR continues to be one of our greatest tools in resuscitating patients in respiratory and cardiac distress. These techniques and more can be found in the free course materials offered to those who build a free account at aclscertificationonline.org. Remember that for all practical purposes several other sources should be referenced when attempting CPR. Greatest success occurs when providers train well in advance with other experienced healthcare providers using appropriate techniques. We hope this article has been educational. Please refer to aclscertificationonline.org for all of your certification and recertification needs.