Performing CPR on Infants

Category: Newborns

Perhaps one of the skills most likely to save your child’s life is knowing how to correctly perform CPR.

WORDS CHRISTEL GERALYN GOMES

Performing CPR on a child is markedly different from adult CPR. It should be performed “in any situation where the infant is unconscious and breathing is either laboured or has stopped, or when the child becomes unconscious from choking or from drowning,” says Dr Goh E. Shaun, specialist in Emergency Medicine and consultant at Raffles Hospital.

 

If you’ve already done a CPR course for adults, know that where you place your hands is different on children due to their smaller sizes.

 

Also, “instead of using a two-handed method as with adults, infant CPR is performed usually by using two fingers,” Dr Goh says.

Dr Sharmila Rengasamy, paediatric registrar at the Royal Children’s Hospital in Melbourne, Australia agrees and says that the protocol is similar to adult CPR, using DRSABC (look for danger, check for response, send for help, check airway, breathing and circulation.)

Dr Goh explains the DRSABC method in more detail:

· First, ensure there is no immediate surrounding danger or obstruction that may make CPR difficult. If there is restrictive clothing, this should be     removed.

· Next, elicit a response from the child by tapping the shoulder or tickling the sole of the foot. If there is no response, assume the child is

  unconscious. Place the infant on his back on a firm, flat surface.

· Have someone call 995 immediately. If you are alone, perform two minutes of CPR before calling 995.

· While someone calls for help, open the airway by performing a head tilt-chin lift – this is done by gently placing the palm of your hand over the        baby’s forehead and then tilting back gently while the other hand lifts the jaw forward.

· Check for breathing by placing your ear and cheek directly above the infant’s mouth and assess for breathing for not more than 10 seconds. If        breathing is present, help the infant to his or her side and wait for further help. If there is laboured or no breathing, start CPR immediately.

To perform CPR, first, locate the correct hand position for chest compressions. According to Dr Goh, this, in an infant, is at the nipple line. “Draw an imaginary line between the nipples with the index finger to the breastbone or sternum. Place your middle and ring fingers next to your index finger. Move the three fingers to the centre of the sternum and position your fingers upright. Lift the index fingers but maintain the middle and ring fingers on the sternum and commence compressions downwards by about 4cm,” he says.

Do not worry about causing harm to the child’s chest. Dr Goh explains that the bones of an infant are mostly cartilage so there is no risk of breaking the sternum or any ribs. What’s more important is that the correct depth is reached and there is adequate relaxation between the compressions.

“To perform breaths, make a tight seal by placing your mouth over the infant’s mouth and nose. Give two breaths simultaneously over the mouth and nose. Give a puff of air from your cheeks with each breath rather than fully exhaling. The chest should be seen to rise with each successive breath. Perform compressions at a rate of 100 per minute and for every 30 compressions there should be two breaths,” Dr Goh adds.

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