By United Medical Education
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This article has Cardiopulmonary Resuscitation (CPR) for ages one to puberty presented in an essay format. For a more abbreviated list of instructions please create a free account on our account page and login to access our free course study materials.
There is a series of techniques commonly used when assessing and treating respiratory and cardiac arrest in a child. These techniques are divided into four categories. These categories are circulation, airway, breathing, and defibrillation (CABD). Becoming familiar with these techniques in the primary CABD survey is imperative for a successful outcome in the event of an emergency. This article will teach you how to best assess and treat a child in respiratory and cardiac arrest when an emergency arises.
Here is a scenario where a child is found collapsed on the ground.
Assess unresponsiveness by attempting to stimulate the child by gently shaking his shoulder and speaking.Â If the child is found to be unresponsive, the collapse went un-witnessed, and you are alone, perform two minutes of CPR and then call 911. If the child is unresponsive, you witnessed the collapse, and you are alone, call 911 immediately and then initiate CPR. If there is another person at the scene, have them call 911 and bring an AED while you initiate CPR immediately. Place the child on a flat hard surface before initiating treatment.
Palpate for a carotid pulse on the child for five to ten seconds.
If the child has a pulse move to the rescue breath portion of the CABD survey. If the child does not have a pulse initiate five cycles of CPR. This will last approximately two minutes. Â Start chest compressions providing 100 compressions per minute or thirty compressions every eighteen seconds. To perform chest compressions place one or both heels of your hands (one hand over the other) on the lower sternum between the child’s nipples. Lock your elbows during chest compressions. During compressions press to 1/3 the depth of the child’s chest. Assure your chest compressions are hard and fast, allow for full chest recoil, and have minimal interruptions. One cycle of CPR is thirty compressions to two rescue breaths. If there are two providers they should switch rolls between giving chest compressions and rescue breaths every five cycles of CPR.
The head tilt chin lift maneuver can be performed by placing one hand on the child’s forehead and applying backward pressure with your palm. This should tilt the head backwards. Next, position the fingers of your other hand under the childâ€™s mental protuberance of the chin and draw the chin forward and cephalic.
A patent airway is required for successful breathing. Two methods are generally used to open the airway. These methods are the head tilt chin lift maneuver and the jaw thrust maneuver. If the collapse of the child was witnessed and a cervical spine injury is not suspected the head tilt chin lift maneuver is appropriate. If the child’s collapse went un-witnessed, if drowning was involved, or if trauma was involved then the jaw thrust technique is appropriate.
The jaw thrust maneuver is performed by positioning your thumbs or fingers on the lower portion of the jaw’s ramus. Then provide anterior pressure to bring the child’s jaw forward.
Bind finger sweeps are not an appropriate technique to open the airway.
Assess the child for normal breathing. When assessing for normal breathing check for chest rise, feel for expelled air, and listen for the audible noise of breathing. If the child is breathing help to maintain a continuous patent airway. If the child is not breathing or if the child’s breathing is inadequate provide the child with two rescue breaths. When giving rescue breaths pinch the child’s nose closed and place your mouth over the mouth of the child, making a seal. Assure that each rescue breath lasts approximately one second. Give the breaths slowly and watch for chest rise. A short time should be allowed between each rescue breath for the air of the previous rescue breath to be expelled. During normal CPR without an advanced airway rescue breaths will be performed approximately six times per minute. If an advanced airway is present rescue breaths should be provided at approximately eight to ten times per minute.
Apply the AED to the child as soon as it arrives. Early defibrillation provides the greatest chance of successful outcomes when a person is in cardiac arrest. Turn on the AED once it arrives and follow it’s audible instructions. Place the appropriate shock pads on the child’s skin and allow for the AED to analyze the child’s heart rhythm. The AED will decide and then advise if the child has a shockable rhythm. If the child’s rhythm isn’t shockable then you should initiate five cycles of CPR before rechecking the rhythm. If the child’s rhythm is shockable assure no one is in contact with the child or a good conductor of electricity by yelling “clear.” Once the providers are clear of an electrical shock deliver a shock to the child. After delivering a shock to the child immediately initiate five cycles of CPR.
Assuring familiarity with the primary CABD survey is imperative for successful outcomes in the event of an emergency. The primary CABD survey should be well researched and practiced from several sources of information to gain a deeper understanding of best practice and theory. Please refer to United Medical Education at aclscertificationonline.org for your certification and recertification needs.