Cardiopulmonary Resuscitation for Children
(Lay Rescuer CPR for Children)
Definition
Cardiopulmonary resuscitation (CPR) is a series of steps to help a person who has stopped breathing and has no heartbeat. CPR manually delivers oxygen to the lungs and temporarily restores the heartbeat. CPR for children is delivered to children aged 1 to 8 years.
Reasons for Procedure
CPR is given to a child who is not breathing. Reasons for this may include:
- Trauma
- Sudden cardiac arrest
- Cerebrovascular accident (bleeding in the brain)
- Burns
- Choking
- Drowning
- Electrical shocks and lightning strikes
- Severe infection
- Drug overdose
- Excessive bleeding
- Hypothermia
The outcome will depend on the initial cause and how soon effective CPR was initiated. Many victims are unable to regain a normal heartbeat after it has stopped.
Possible Complications
In frail children, it is possible that ribs may fracture or break during chest compressions. Other complications, like a puncture of a lung, are also possible.
People with weakened bones have a higher risk of bone fractures from CPR. However, there is far greater risk of death if CPR is delayed or not done correctly.
What to Do
Prior to Procedure
When you see a child suddenly collapse or find a child unconscious on the ground, immediately check to see if he or she is responsive. Tap the victim and ask: “Are you OK?” If the victim is unresponsive, then follow these three steps.
Step 1: Call 911 immediately and check for breathing
- If someone is with you, have them make the call.
- If you are alone, perform CPR for at least 1-2 minutes (5 cycles) before dialing 911.
- If an automatic external defibrillator (AED) is available, have it brought to the scene. If you are alone, retrieve the AED when you call for help.
- Check for breathing. If the victim is not breathing, begin CPR.
Step 2: Give mouth-to-mouth resuscitation
- Position the child so that he or she is lying on their back.
- Open the airway by placing one hand on the forehead and lifting the chin with your other hand.
- Gently tilting the head backward, pinch the child's nose and cover his or her mouth with yours.
- Breathe twice into the child's mouth until you see the chest rise. Breaths should be about one second each.
Step 3: Do chest compressions
- Place the heel of one hand palm down on the chest. Use 1 or 2 hands as needed.
- Straighten your arms and lock your elbows. Begin pressing down in a straight motion. The compressions should be about 1/3 to 1/2 the depth of the chest.
- Push hard. Push fast. Push at a rate of 100 compressions/minute.
- Allow the chest to rise completely between compressions.
- Minimize interruption between compressions.
- After 30 compressions, give two rescue breaths.
After 1-2 minutes of CPR, if you have not called 911, do so. Call even if the child has regained consciousness and is breathing on his own. The child will need to be taken to the hospital for evaluation following CPR.
Use AED after performing CPR for 5 cycles of 2 breaths and 30 chest compressions.
- Turn the AED on.
- Attach the pads.
- Follow the prompts. If advised, deliver the shock. If the shock is not advised, the AED will tell you to resume CPR.
Continue cycles of 30 compressions and 2 breaths until one of the following occurs:
- Medical help arrives
- It becomes unsafe to continue
- The victim regains consciousness and is able to breathe
Chest Cavity and Air Pathway
How Long Will It Take?
The length of time for CPR depends on the underlying causes and response time of medical help.
Will It Hurt the Child?
The patient is unconscious when CPR is given. The procedure does not hurt. Some victims may complain of soreness in the chest after regaining consciousness.
Post-procedure Care
The emergency team will take over care when they arrive.
Victims will need to be taken to the hospital for evaluation following CPR.
RESOURCES:
American Heart Association
www.americanheart.org/
American Red Cross
http://www.redcross.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/
Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/
References:
American Heart Association guidelines. 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support. Pediatrics. 2006;117(5):e989-1004. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=16651298. Accessed January 12, 2009.
American Heart Association. Heartsaver First Aid with CPR and AED. Dallas, TX: American Heart Association; 2006
American Red Cross website. Available at: http://www.redcross.org.
Bush CM, Jones JS, Cohle SD, Johnson H. Pediatric injuries from cardiopulmonary resuscitation. Ann Emerg Med. 1996;28(1):40-44. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8669737&dopt=Abstract. Accessed January 12, 2009.
Topjian AA, Berg RA, Nadkarni VM.Pediatric cardiopulmonary resuscitation: advances in science, techniques, and outcomes. Pediatrics. 2008 Nov;122(5):1086-98. Review.
Last reviewed October 2009 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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