Responding to Children Who are Not Breathing

Responding to Children Who are Not Breathing or Without a Pulse CPR stands for cardiopulmonary resuscitation. It is a lifesaving procedure that is done when a child’s breathing or heartbeat has stopped. This may happen after drowning, suffocation, choking, or an injury. CPR involves:

 Rescue breathing, which provides oxygen to a child’s lungs

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 Chest compressions, which keep the child’s blood circulating Permanent brain damage or death can occur within minutes if a child’s blood flow stops. Therefore, you must continue CPR until the child’s heartbeat and breathing return, or trained medical help arrives. CPR is best done by someone trained in an accredited CPR course. The newest techniques emphasize compression over rescue breathing and airway management, reversing a long- standing practice. The procedures described here are NOT a substitute for CPR training. Machines called automated external defibrillators (AEDs) can be found in many public places and can be purchased for homes and early care and education programs. These machines have pads or paddles to place on the chest during a life-threatening emergency. They use computers to automatically check the heart rhythm and give a sudden shock if, and only if, that shock is needed to get the heart back into the right rhythm. When using an AED, follow the instructions exactly.

CPR for Infants (under 1 year of age) 1. Check for responsiveness. Shake or tap the infant gently. See if the infant moves or

makes a noise. Shout, “Are you OK?” 2. If there is no response, shout for help. Send someone to call 911. Do not leave the infant

yourself to call 911 until you have performed CPR for about 2 minutes.

3. Carefully place the infant on their back. If there is a chance the infant has a spinal injury, two people should move the infant to prevent the head and neck from twisting.36

4. Perform chest compressions:

 Place 2 fingers on the breastbone — just below the nipples. Make sure not to press at the very end of the breastbone.

 Keep your other hand on the infant’s forehead, keeping the head tilted back.

 Press down on the infant’s chest so that it compresses about 1/3 to 1/2 the depth of the chest.

 Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be FAST and hard with no pausing. Count the 30 compressions quickly: “1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, off.”37

5. Open the airway. Lift up the chin with one hand. At the same time, push down on the forehead with the other hand.

6. Look, listen, and feel for breathing. Place your ear close to the infant’s mouth and nose. Watch for chest movement. Feel for breath on your cheek.

7. If the infant is not breathing:

 Cover the infant’s mouth and nose tightly with your mouth.

 Alternatively, cover just the nose. Hold the mouth shut.

 Keep the chin lifted and head tilted.

 Give 2 breaths. Each breath should take about a second and make the chest rise. 8. Continue CPR (30 chest compressions followed by 2 breaths, then repeat) for about 2

minutes. 9. After about 2 minutes of CPR, if the infant still does not have normal breathing,

coughing, or any movement, leave the infant to call 911. 10. Repeat rescue breathing and chest compressions until the infant recovers or help

arrives. If the infant starts breathing again, place them in the recovery position. Periodically re-check for breathing until help arrives.