How to Perform CPR on a Child: A Step-by-Step Guide
Performing CPR on a child is a life-saving skill that every parent, caregiver, and responsible adult should know. Children, especially infants and toddlers, are at a higher risk of respiratory distress and cardiac arrest due to various factors such as choking, drowning, accidents, and underlying medical conditions. Knowing how to administer CPR correctly can significantly increase a child’s chances of survival until professional medical help arrives. This comprehensive guide provides detailed, step-by-step instructions on how to perform CPR on a child, along with essential information to help you act confidently and effectively in an emergency.
Important Considerations Before You Begin
Before diving into the steps of CPR, it’s crucial to understand the differences between child CPR and adult CPR. A child is defined as someone between the ages of 1 and puberty. Infants (under 1 year old) require a different set of CPR techniques, which will be covered in a separate article. Also, remember that this guide provides general information and is not a substitute for professional CPR certification. Consider taking a certified CPR course to gain hands-on experience and confidence.
Key Differences Between Child and Adult CPR:
* Compression Depth: Child CPR requires less compression depth than adult CPR.
* Hand Placement: The hand placement for chest compressions differs slightly.
* Ventilation Ratio: The ratio of compressions to breaths may vary.
Assessing the Situation
1. Ensure Scene Safety:
Your safety is paramount. Before approaching the child, assess the surroundings to ensure they are safe for both you and the child. Remove any hazards, such as traffic, fire, or electrical wires, if possible.
2. Check for Responsiveness:
* Approach the child calmly and gently.
* Tap or gently shake the child’s shoulder.
* Shout, “Are you okay?” or “Can you hear me?”
If the child responds by moving, speaking, or making any sound, they are conscious. Assess their condition and provide appropriate first aid based on their injuries or symptoms. If the child is unresponsive, proceed to the next step.
3. Call for Help or Delegate:
The most critical step is to activate the emergency medical system. Designate someone to call 911 (or your local emergency number) and provide the dispatcher with the following information:
* Your location
* The child’s approximate age
* The child’s condition (unconscious and not breathing)
* The type of assistance needed (CPR)
If you are alone, try to put your phone on speaker and keep it near you so the dispatcher can guide you through the process. If you must leave the child to call for help, do so quickly, but prioritize calling before starting CPR if possible.
4. Check for Breathing:
After calling for help, quickly check for signs of breathing. Look for chest rise and fall, listen for breath sounds, and feel for air on your cheek. Do this for no more than 10 seconds. Gasping, infrequent, or shallow breaths are not considered normal breathing.
Performing Child CPR: The Steps
If the child is unresponsive and not breathing or only gasping, begin CPR immediately. Remember the acronym CAB: Compressions, Airway, Breathing.
1. Compressions (C):
* Position the Child: Place the child on a firm, flat surface, such as the floor or ground. Kneel beside the child.
* Hand Placement:
* For older children (generally those who are bigger), use the heel of one hand in the center of the child’s chest, on the lower half of the breastbone. Avoid pressing on the bottom tip of the breastbone (xiphoid process).
* For younger children, you may only need to use one hand. If the child is very small, you may even use two fingers.
* Compression Technique:
* Place your hand(s) correctly on the child’s chest.
* Keep your elbows straight and position your shoulders directly above your hands.
* Use your body weight to compress the chest approximately 2 inches (about one-third the depth of the chest). Avoid excessive force.
* Compression Rate:
* Perform chest compressions at a rate of 100-120 compressions per minute. This is faster than you might think; try to follow the beat of a familiar song like “Staying Alive” or “Baby Shark.”
* Allow for Recoil:
* After each compression, allow the chest to fully recoil (return to its normal position) before starting the next compression. This allows the heart to refill with blood.
* Continue Compressions:
* Continue chest compressions for 30 compressions.
2. Airway (A):
After 30 chest compressions, open the child’s airway using the head-tilt/chin-lift maneuver:
* Head-Tilt/Chin-Lift:
* Place one hand on the child’s forehead and gently tilt the head back.
* Place the fingers of your other hand under the child’s chin and lift the chin forward. Be careful not to press on the soft tissues under the chin, as this can obstruct the airway.
* Avoid hyperextending the neck, especially in infants and young children, as this can close off the airway. Use a neutral or slightly extended position.
If you suspect a spinal injury, use the jaw-thrust maneuver instead:
* Jaw-Thrust:
* Place your fingers behind the angles of the child’s jaw and lift the jaw forward. This technique helps to open the airway without tilting the head.
3. Breathing (B):
After opening the airway, give two rescue breaths:
* Pinch the Nose: Use your thumb and index finger to pinch the child’s nose closed.
* Create a Seal: Place your mouth over the child’s mouth, creating a tight seal. For smaller children, you may need to cover both the mouth and nose with your mouth.
* Give Rescue Breaths: Give two rescue breaths, each lasting about one second. Watch for the chest to rise with each breath. If the chest doesn’t rise, recheck the airway for obstruction and ensure a proper seal.
* Avoid Over-Inflation: Give gentle breaths and avoid over-inflating the lungs, as this can cause injury.
4. Continue CPR Cycles:
Continue cycles of 30 chest compressions and 2 rescue breaths (30:2) until:
* The child shows signs of life (e.g., breathing, moving, coughing).
* Emergency medical services arrive and take over.
* You are too exhausted to continue.
Choking Considerations
If you suspect the child is choking, look for signs such as:
* Inability to speak or cry
* Weak or ineffective cough
* Bluish skin color (cyanosis)
* Clutching at the throat (universal choking sign)
If the Child is Conscious and Choking:
* Encourage Coughing: Encourage the child to cough forcefully to dislodge the object.
* Back Blows and Abdominal Thrusts: If the child is unable to cough effectively, perform a combination of back blows and abdominal thrusts (Heimlich maneuver).
* Back Blows: Hold the child face down, supporting their chest and jaw. Deliver five firm back blows between the shoulder blades using the heel of your hand.
* Abdominal Thrusts: If back blows are unsuccessful, perform five abdominal thrusts. Stand behind the child, wrap your arms around their waist, and make a fist with one hand. Place the thumb side of your fist against the child’s abdomen, slightly above the navel. Grasp your fist with your other hand and give five quick, upward thrusts into the abdomen.
* Alternate Back Blows and Abdominal Thrusts: Continue alternating between five back blows and five abdominal thrusts until the object is dislodged or the child becomes unconscious.
If the Child is Unconscious and Choking:
* Begin CPR: If the child becomes unconscious, immediately begin CPR, starting with chest compressions.
* Look for Obstruction: Each time you open the airway to give rescue breaths, look for a foreign object in the child’s mouth. If you see an object, carefully remove it with your finger.
* Continue CPR: Continue CPR cycles until the object is dislodged or emergency medical services arrive.
Important Considerations and Tips
* Stay Calm: It’s natural to feel anxious or scared in an emergency situation, but try to remain calm. Your composure will help you think clearly and act effectively.
* Delegate Tasks: If there are other people present, delegate tasks such as calling 911, gathering supplies, or comforting other children.
* Follow Dispatcher Instructions: The 911 dispatcher can provide valuable guidance and support. Follow their instructions carefully.
* Consider Your Limitations: Be aware of your physical limitations and don’t hesitate to ask for help if needed. CPR can be physically demanding, and it’s important to avoid exhaustion.
* Take a CPR Course: The best way to learn CPR is to take a certified course. A course will provide hands-on training and allow you to practice the techniques under the supervision of a qualified instructor. Organizations such as the American Heart Association and the American Red Cross offer CPR courses.
* Practice Regularly: Even after taking a CPR course, it’s important to practice the techniques regularly to maintain your skills. Use a CPR training manikin to practice compressions and rescue breaths.
* Stay Updated: CPR guidelines are updated periodically based on the latest research and best practices. Stay informed about the current guidelines and update your skills accordingly.
* Emotional Support: Providing CPR to a child can be emotionally traumatic. Seek emotional support from friends, family, or a professional counselor if needed.
* Document the Event: After the emergency, document the event as accurately as possible. This information may be helpful for medical professionals and for your own emotional processing.
Legal Considerations
Good Samaritan laws generally protect individuals who provide emergency assistance in good faith. However, it’s important to understand the laws in your specific jurisdiction.
* Act in Good Faith: Provide assistance to the best of your ability and without recklessness or negligence.
* Obtain Consent: If the child is conscious and able to understand, obtain their consent before providing assistance. If the child is unconscious, implied consent is assumed.
* Don’t Abandon: Once you have started providing assistance, don’t abandon the child until emergency medical services arrive or you are relieved by another qualified person.
CPR Training Resources
* American Heart Association: Offers a variety of CPR courses for adults, children, and infants. Visit their website or call their local chapter for more information.
* American Red Cross: Provides CPR training and certification programs. Check their website for course schedules and locations.
* Local Hospitals and Community Centers: Many hospitals and community centers offer CPR courses to the public. Contact your local hospital or community center for more information.
Conclusion
Knowing how to perform CPR on a child is a crucial skill that can save lives. By following the steps outlined in this guide and taking a certified CPR course, you can be prepared to act confidently and effectively in an emergency situation. Remember to stay calm, call for help, and continue CPR cycles until professional medical assistance arrives. Your quick action and knowledge can make a life-saving difference. This guide is for informational purposes only and does not substitute for professional medical training. Always seek the advice of qualified healthcare providers for any health concerns or before making any decisions related to your health or treatment.