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Child CPR refresher

Infant and Child Cpr Refresher steps
March 18, 2013 at 5:33 pm Comments disabled
To perform CPR on a child

The procedure for giving CPR to a child age 1 through 8 is essentially the same as that for an adult. The differences are as follows:

If you’re alone, perform five cycles of compressions and breaths on the child — this should take about two minutes — before calling 911 or your local emergency number or using an AED.
Use only one hand to perform heart compressions.
Breathe more gently.
Use the same compression-breath rate as is used for adults: 30 compressions followed by two breaths. This is one cycle. Following the two breaths, immediately begin the next cycle of compressions and breaths.
After five cycles (about two minutes) of CPR, if there is no response and an AED is available, apply it and follow the prompts. Use pediatric pads if available. If pediatric pads aren’t available, use adult pads.
Continue until the child moves or help arrives.

To perform CPR on a baby

Most cardiac arrests in babies occur from lack of oxygen, such as from drowning or choking. If you know the baby has an airway obstruction, perform first aid for choking. If you don’t know why the baby isn’t breathing, perform CPR.

To begin, examine the situation. Stroke the baby and watch for a response, such as movement, but don’t shake the baby.

If there’s no response, follow the CAB procedures below and time the call for help as follows:

If you’re the only rescuer and CPR is needed, do CPR for two minutes — about five cycles — before calling 911 or your local emergency number.
If another person is available, have that person call for help immediately while you attend to the baby.
Circulation: Restore blood circulation

Place the baby on his or her back on a firm, flat surface, such as a table. The floor or ground also will do.
Imagine a horizontal line drawn between the baby’s nipples. Place two fingers of one hand just below this line, in the center of the chest.
Gently compress the chest about 1.5 inches (about 4 cm).
Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate of 100 compressions a minute.
Airway: Clear the airway

After 30 compressions, gently tip the head back by lifting the chin with one hand and pushing down on the forehead with the other hand.
In no more than 10 seconds, put your ear near the baby’s mouth and check for breathing: Look for chest motion, listen for breath sounds, and feel for breath on your cheek and ear.
Breathing: Breathe for the infant

Cover the baby’s mouth and nose with your mouth.
Prepare to give two rescue breaths. Use the strength of your cheeks to deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into the baby’s mouth one time, taking one second for the breath. Watch to see if the baby’s chest rises. If it does, give a second rescue breath. If the chest does not rise, repeat the head-tilt, chin-lift maneuver and then give the second breath.
If the baby’s chest still doesn’t rise, examine the mouth to make sure no foreign material is inside. If the object is seen, sweep it out with your finger. If the airway seems blocked, perform first aid for a choking baby.
Give two breaths after every 30 chest compressions.
Perform CPR for about two minutes before calling for help unless someone else can make the call while you attend to the baby.
Continue CPR until you see signs of life or until medical personnel arrive.

CPR Chest Compression Only has long term benefits

People who suffer cardiac arrest - in which the heart stops beating - were less likely to die in subsequent years when bystanders performed cardiopulmonary resuscitation using chest compressions only, a new study found.
That builds on previous research that found no short-term survival differences in adult victims given compression-only CPR instead of the standard kind, which includes mouth-to-mouth resuscitation.
And it supports an American Heart Association recommendation that the simpler form of CPR is appropriate for bystanders, who may feel so intimidated by the prospect of combining chest compressions with rescue breathing that they give no aid at all.
This study shows "we were on the right track in 2008," said Dr. Roger White of the Mayo Clinic, who was on the advisory group that wrote the AHA's statement.
The recommendations don't apply to CPR performed in the hospital, nor in the community by medical personnel or people who are proficient in rescue breathing. They also apply only to adult, not pediatric, victims.
Some 383,000 people in the U.S. suffer cardiac arrests every year, and only about 10 percent survive.
The study looked at data from two randomized trials that were published in the New England Journal of Medicine in 2010 and covered more than 3,200 adults whose cardiac arrests were likely due to heart problems rather than trauma, suffocating or drowning. Dispatchers instructed bystanders via phone to use either the standard or compression-only form of CPR.
The new study's authors, who were from Seattle, France and Sweden, were able to follow up on longer-term outcomes for 78 percent of those participants.
The one-year survival rate was about 12 percent for chest compression alone and about 10 percent for compression plus breathing, said Dr. Florence Dumas, an author of the study, in an email to Reuters Health. After adjusting for different factors, mortality in the compression-only group was 9 percent lower than in the standard CPR group. The survival benefit persisted over five years, according to findings published in the journal Circulation.
That suggests "that potential short-term outcome differences do translate to meaningful long-term public health benefits," said Dumas.
Allaying Concerns
In 2008 the AHA said compression-only CPR was an option for bystanders who aren't trained or who aren't confident in their ability to perform the compressions combined with rescue breathing.
Some people have worried that collapsed victims of non-cardiac events such as drug overdoses or a blood clot in the lungs might not get the oxygen they need with the compression-only approach, he said.
But the study authors wrote that, "importantly, we did not observe evidence of harm among those for whom oxygenation and ventilation might in theory be more important" such as non-cardiac causes or an unwitnessed cardiac arrest.
There is likely some oxygen remaining in the blood when a victim's heart has stopped for a short period of time, and the compression-only technique can distribute it to vital organs. If a person has been down for a longer or unknown period of time, it's more likely that they'll need fresh oxygen through rescue breathing, said White, an anesthesiologist and cardiac care specialist who was not involved in the new study.
That's why the AHA's recommendations apply when bystanders actually witness an adult suffering cardiac arrest with no obvious non-cardiac cause such as drowning. (Kids suffering cardiac arrest need rescue breathing.)
"The vast majority (of events) are likely to be cardiac in origin," said White. "So proceeding with chest compression is likely to be beneficial in the vast majority of cases," he said.
One limitation of the study was that it tracked survival only; it couldn't assess patients' level of function or quality of life. In addition, the original trials the study drew from weren't designed to track long-term outcomes.