CPR Steps in Children
The American Heart Association defines cardiopulmonary resuscitation, or CPR, as a type of breathing combined with chest compressions. It is the recommended care for rescuing victims who may be in cardiac arrest, which is an emergent situation that occurs when the heart stops pumping blood. CPR can buy a victim minutes before medical help arrives, which can be the difference between life and death. The guidelines for administering CPR to a child and an adult only differ slightly.
There are only a few key differences when performing CPR on a child instead of an adult. They exist in the amount of cycles before calling 9-1-1—about 2 minutes for a child. Also with children, ages 1 to 8 years old, because of their size, you will most likely use the one-hand-only technique as opposed to the two-handed technique used on an adult. Finally, the force is slightly adjusted for size when compressing the chest. A child’s chest should only be compressed about one third of the way. But the basic steps are the same.
Assess the Situation
Assess the scene before beginning CPR. Do it quickly, thoroughly and with authority. Determine whether you are likely to be in immediate danger. It makes no sense to begin working on a victim if you could be in danger. Ask the victim, “Are you alright?” If you know the child, address him or her by name. “Drew, are you OK? Drew, talk to me?” Also tap the victim forcefully while loudly repeating, “Can you hear me?” You must confirm first that the victim is unresponsive. If this person is indeed unresponsive, call 9-1-1. If you are alone, you will need to complete 2 minutes of CPR before calling emergency services. If you are not alone, shout the command, “Call 9-1-1. I will perform CPR. You call 9-1-1.” If the child is breathing but is determined to be unconscious, you must still call 9-1-1. Make sure the victim is supine on a hard surface. However be careful when moving a child. There may be a spinal injury. If it is determined that you must move the child, do it carefully and try to move the back and neck supported and as one unit.
Unblock the Airway
Check the airway. Gently tilt the child’s head back and chin up to open up the airway. Now actually look in the airway to make sure nothing is obstructing it. Gently sweep the airway with your fingers. If there is something obstructing his or her airway, no amount of CPR will work because the breath won’t reach the child’s lungs.
Breathing for the Victim
With the head tilted and the airway properly determined to be open, you are ready to administer resuscitative breaths. First pinch the victim’s nose, inhale, cover the child’s mouth with yours, keep the head tilted and give two slow breaths. These breaths should be administered in 1-second intervals. If you do not see the chest expand and rise, go back to the previous step of opening the airway.
Signs of Life
Look for signs of circulation. The child moves, coughs or twitches. Listen to see if breath has returned to normal. If the child is not breathing, you must do chest compressions. The ratio for compressions to breaths is 30 to 2. Now place the heel of your hand in the center of the chest. Keep your other hand on the forehead to keep the child’s head tilted back. Now press down about one third of the way 30 times quickly and evenly and count. Now deliver two slow breaths. Watch the chest rise. Return to compressions. If there are still no signs of circulation and you are alone, you must leave the child momentarily and call 9-1-1. Then return to the victim and repeat the cycle until the child is breathing on his or her own or until help arrives.