Cardiac arrest in infants can be extremely deadly; as many as 90% of out-of-hospital cardiac arrests result in death in the US yearly. Approximately 23,000 pediatric out-of-hospital cardiac arrests occur in the US on an annual level. Out of these, 19.2% (4,515) are recorded in infants, i.e. children younger than one.
The numbers show that cardiac arrest is quite common among infants but also that, in most cases, it results in infantile death. This makes it essential for parents, caregivers, and adults, in general, to learn the specifics of infant CPR. Timely response and properly executed CPR can be the very things that save some young lives.
But how do you perform infant CPR? Keep reading to learn which techniques are applied.
What Is Infant CPR?
Infant cardiopulmonary resuscitation, or infant CPR, is a procedure used when an infant’s heart has stopped (cardiac arrest) or when they’ve ceased breathing (respiratory arrest). These two medical conditions can occur due to a variety of reasons, such as:
- Other injuries or diseases.
If any of the above reasons apply, and the infant’s breathing or heart has stopped, CPR needs to be administered. With infants, it’s important that both chest compressions and rescue breathing are applied when providing CPR to ensure that both the blood flow and the oxygen flow in the body are restored as soon as possible.
Permanent brain damage can occur in as little as 4 minutes, while death can occur 4 to 6 minutes later. So, it’s important to combine these two forms of CPR right away.
How Is Infant CPR Different from Adult CPR?
Even though the essence of all CPR is the same, there are some key differences when performing this procedure on adults vs children. The first thing you need to remember about infant CPR is that it requires less force; the excessive use of force in infant CPR can make the situation worse.
Before beginning with compressions or rescue breaths, you’ll need to check if the person is responsive. This is easier with adults — you can shake them and even gently slap them to get them to respond.
However, you mustn’t do this with babies. You need to be gentle. Talk loudly and caress them; if they don’t respond, it’s a sign to start CPR.
Other important differences are the force and the speed with which the compressions are applied. With infants, you only need to use two fingers for the compressions while delivering more compressions per minute — approximately a hundred. Additionally, the rescue breaths need to be less intense, so you’ll need to blow only a little air into the infant’s lungs.
How to Perform Infant CPR: Step-by-Step
When an infant is unresponsive, has ceased breathing, and shows no signs of heart action, you must administer CPR. It’s important to go about this in the right way, so be sure to follow the steps as they are presented below:
#1 Check for Responsiveness
The first thing you need to do before you take any course of action is to check whether the infant is responsive. Call out their name and talk loudly to see if they open their eyes; you can also caress them or tap the soles of their feet to check for a physical reaction.
The next thing to check is whether the infant is breathing; look closely at the chest to see if it rises and falls in regular intervals. Another sign that a baby is not getting enough oxygen is cyanosis, i.e. blue coloring of the infant’s skin and/or lips.
#2 Call 911
Once you’ve determined that the infant is unresponsive, you need to call for help. Dial 911 and report the situation; make sure to tell them that an infant is unresponsive.
In addition to sending the emergency response team, the dispatcher may provide some instructions on how to proceed in this situation, either with CPR or with an AED — if there is one in your vicinity.
While you wait for the team, you’ll need to start resuscitation, as there is no time to waste. When the EMS arrive at the scene, they will take over the resuscitation process and transport the child to a hospital.
#3 Start Chest Compressions
How do you perform infant CPR? You’ll start with chest compressions.
When performing compressions on an infant, you only need to use two fingers. This is known as the two-finger technique and has been widely used for infant CPR. There have been some studies into other techniques, such as the 2-thumb technique, but it’s best if you use a technique you are familiar with.
Place two fingers or two thumbs in the middle of the baby’s chest. Using the two fingers, press down on the baby’s chest at a depth of 1 ½ inches. Allow the chest to return to normal after each compression and make sure you give 30 compressions at a rate of 100-120 per minute. It’s important to keep up this pace to ensure that the circulation is restored to all parts of the infant’s body.
#4 Provide Rescue Breathing
The second part of infant CPR consists of rescue breaths. However, before you start giving rescue breaths, you need to make sure that the baby’s airway is unobstructed. Check the mouth and nose for any physical barriers that might be blocking the air from entering the lungs.
If you’re sure the airway is clear, gently tilt the baby’s head back and start blowing in their mouth and nose. Each breath should last about one second, and the baby’s chest should rise every time you blow into their mouth. You should provide a breath every 2 to 3 seconds to reach a rate of 20 to 30 breaths per minute.
#5 Continue the CPR Cycle
With infants, the recommended CPR cycle consists of 30 compressions and 2 breaths. Repeat this cycle until help arrives at the scene or until you’ve restored normal breathing and heart function in the infant. Ensure that you’ve repeated at least 5 CPR cycles before taking a break. Remember that this is recommended for infants under 1, not older children.
However, even if you’ve managed to get the baby to breathe again and restored their heartbeat, you still need to wait for the emergency response team. They’ll take the child to a hospital where medical professionals can determine what caused the cardiac/respiratory arrest and try to prevent it from happening again.
#6 Use an AED
If an AED is available, and you know how to use it, you can stop with CPR and use the device to shock the infant’s heart into a normal rhythm. Some AEDs have a pediatric setting, but even if they don’t, they’re still safe to use on infants — you just need to be careful of the AED placement.
The safest way to use an AED on an infant is by placing one pad on the chest and the other on the baby’s back to ensure the two pads aren’t touching each other. The device will analyze the heart’s rhythm and determine whether a shock needs to be delivered; if so, press the shock button. After the shock, resume CPR until the infant becomes responsive or the EMS arrive.
#7 Accompany the Child to the Hospital
When the emergency response team arrives at the scene, go with them and make sure that the child arrives safely at the hospital in the neonatal or pediatric unit — where any necessary medical intervention will be provided.
After this, the only thing left to do is stay close to the infant and remain up-to-date on their condition. These situations are stressful and difficult to manage. However, by getting CPR training and certification, you can significantly increase the infant’s chances of survival.
Infants are more sensitive than adults, so cardiac and respiratory arrests are a much bigger risk for them and are more likely to result in fatal outcomes. Seeing as there’s not much that can be done to prevent these events, the next best thing is to learn to provide CPR to unresponsive infants.
Every adult, but particularly parents and caregivers, should undergo CPR training and get a certification for infant CPR. By getting certified, they will be able to properly assess the situation and react quickly. Time is of the essence with infants in distress!
Providing proper infant CPR as soon as possible draws the line between life and death. Therefore, everyone should get the necessary training and save a baby’s life if needed.