Cardiac Resuscitation (Cpr) In Children

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Last Medical Review: March 28, 2020
Medically Reviewed by Dr. David Costa Navarro

Cardiac resuscitation

Cardiovascular rescue, which is usually abbreviated CPR, is a first aid treatment that you can give to someone who has stopped breathing or to someone whose heart has stopped beating.

Cardiac resuscitation consists of two steps: breathing and chest compressions. Breaths, also called mouth-to-mouth breaths, are made to supply oxygen to the blood. Chest compressions involve rhythmically pressing with the hands on the chest to allow blood to circulate in the body. This way you can try to get your breathing and heart activity going again.

Cardiopulmonary rescue

If you find a child who appears lifeless, start by finding out how serious the condition is by checking if the child is conscious, if it is breathing, or if it shows any other signs of life. It is important that this check goes fast.

If the child is unconscious but breathing normally, put it in stable lateral position and then dial 112.

If, on the other hand, the child is unable to breathe normally or does not show signs of life, you should start doing cardiovascular rescue. If you are alone, it is important that you first give the child initial cardiopulmonary resuscitation and then alarm 112. If you are several, someone can call 112, while another person starts cardiopulmonary resuscitation.

Give mouth to mouth breathing immediately

It is very uncommon for the heart to stop beating in children. The most common reason why children become inanimate is that they have stopped breathing.

Children are very sensitive to oxygen deficiency and therefore it is important that you give mouth to mouth breathing as soon as possible in an emergency. When breathing ceases, the body does not get enough oxygen and eventually the heart can stop beating. In this situation, you also need to get your heart’s activity started with chest compressions.

The brain is the organ that is most sensitive to oxygen deficiency. If the oxygen supply does not start quickly enough, there is a risk that the child will suffer permanent brain damage. Such damage can occur after a few minutes. If the body is cooled down, the brain can handle the oxygen deficiency a little longer.

Heart-lung rescue depending on the child’s age

The technique of cardiovascular rescue is different depending on the age of the child. The information in this text provides an overview of how to do cardiac resuscitation. It can be good for both orientation and repetition.

This text contains information for children up to puberty. For older children and adults you will find information here.

Heart-lung rescue on children – so it goes

Cardiac resuscitation differs in how you do chest compressions and breaths, depending on whether the child is younger or older than one year.

In the following films, you will learn how to do cardiac rescue in children. The first film is about heart-lung rescue in children younger than one year. The second film deals with cardiac resuscitation on children older than one year.

Heart-lung rescue on children

Check if the child is conscious

  • Address or shout at the child.
  • Pinch or shake the baby gently in the shoulders.

If you do not get a reaction from the child, you must assume that the child is unconscious. If you are in a place where there are other people, you should call for help.

Check if the baby is breathing

Open the airways:

  • Place the child on his back on a flat surface.
  • Place one hand on the baby’s forehead.
  • Lift the baby’s chin by placing two fingers under the chin and gently lift the chin upwards. Make sure not to push the soft parts under the baby’s lower jaw.

Check if the baby is breathing:

  • Watch for chest and stomach moving.
  • Listen for air flowing in and out by putting your ear near the baby’s mouth and nose.
  • Hold the cheek over the baby’s nose and mouth and feel the air flow out.

If you cannot see, hear or feel any breathing, you must assume that the child has a breathing stop. Then immediately start mouth-to-mouth.

If the child is breathing normally but is unconscious, place it in stable lateral position and then dial 112.

Mouth to mouth breathing – does 5 breaths:

  • Continue to keep the airways open by holding one hand on the forehead and two fingers on the chin tip.
  • If the child is younger than one year, put your mouth tightly over both nose and mouth. If the child is older than one year, you should instead squeeze the child’s nostrils with the hand you hold on the forehead. This is done to prevent breathing air from entering the baby’s nose instead of into the lungs.
  • Make 5 slow breaths with no more than enough air in your own mouth. Adjust the amount to fit the child’s size. Small children have small lungs. Blowing in the air should take about 1 second per breath. Make sure that the chest rises as you breathe in air. As the chest rises, stop breathing. Make sure the chest lowers as the baby exhales.

Check if the child shows signs of life:

  • Look if the child shows any signs of life, for example if it swallows or moves.
  • Watch, listen and feel if the child is breathing with normal breath. At cardiac arrest, the child may continue to take occasional, irregular breaths that may sound like sighs. This breathing is not normal and does not provide oxygenation to the body.

If the child does not show any signs of life, but for example has gray skin color and is limp in the body, you must do cardio-pulmonary rescue with chest compressions. You should trust your judgment. It is not dangerous to do chest compressions in a child even if the heart beats.

If the child shows signs of life but does not breathe normally, continue with mouth to mouth breathing only.

If the child shows signs of life but does not breathe normally: Do mouth to mouth breathing with 20 breaths

  • Do 20 breaths for 1 minute.
  • Call 112.
  • Continue doing 20 breaths per minute until the ambulance arrives.

While waiting for the ambulance, check the life signs every two minutes. There is a risk that the lack of oxygen causes the heart to stop beating.

If the child does not show signs of life: Switch between 30 chest compressions and 2 breaths

Do alternately 30 chest compressions and 2 breaths.

Chest compressions – makes 30 pressure:

  • The child should lie on his back on a hard surface.
  • If the child is younger than one year, place your index finger and middle finger in the middle of the chest, on the lower half of the sternum. Be careful not to place your fingers too far down on your stomach so that they end up on the sternum.
  • If the child is older than one year, place your palm on the chest, on the lower part of the sternum. Lean over the child with a straight arm. Your shoulder should be directly above the hand you press. Be careful not to place your hand too far down on your stomach so that they end up on the sternum.
  • Press down one-third of the chest depth, about four centimeters on smaller children or five centimeters on children over a year, 30 times. The speed should be a little faster than one pressure per second, 100-120 compressions per minute.

Make 2 breaths:

Perform the series of alternating 30 compressions and 2 breaths in total three times before alarm 911.

  • Call 911.
  • Continue to alternate 30 chest compressions and 2 breaths until the ambulance arrives or until the child shows signs of life.

You should try to do the steps without interruption, at an even pace. Do not pause to check for signs of life and avoid long breaks when switching between compressions and inlets. It is strenuous to do cardio-pulmonary rescue and it is good if there can be several who help. In this case, one should change after two minutes. It is important not to give up.

After the cardiac rescue

Druming experience

The child does not experience any discomfort with the treatment itself because it is unconscious. However, when the child wakes up, knowing about what has happened can be daunting. Therefore, it may need help processing the event.

If you have taken care of a child who has been unconscious and been allowed to do cardiac rescue, you may also need someone to talk to after the relief effort. For example, you can contact the ambulance staff later to have the opportunity to talk through your experiences.

You can also have the opportunity to talk to the staff at the emergency room who was taking care of the child. You can meet a curator and talk about what has happened.

It is good to know that the Privacy Act limits the ability of healthcare professionals to provide information about the event itself.

Contact number in the phone

ICE phone number of relatives in the mobile phone

As a parent, you can enter the abbreviation ICE and a telephone number on the child’s mobile phone. This makes it easier for the health care staff to get in touch with relatives if the child happens to have something.

ICE stands for English’s “In Case of Emergency”, which means “in case of an emergency”. It is now used internationally.

You first enter ICE and then the name of a contact person in the mobile phone’s phonebook. You can add more contacts under ICE1, ICE2 and so on.

When you enter the phone number, you can start with the plus sign and then the international prefix 46. Then the number will work in whatever country you are in.

Easy to learn

In order to do the simplest form of cardio-pulmonary rescue, no equipment is needed. It is a method that everyone can learn. You only need to take a short course of a couple of hours to learn how to do it. Then you get to practice performing the treatment on an exercise doll to be sure of the technique. Some elements may otherwise be difficult to do properly.

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