Cardio pulmonary resuscitation (CPR) is an emergency measure administered to people who are not breathing on their own. With a small amount of knowledge and training, anyone can perform CPR. It is a very effective method of ensuring oxygen is supplied to the brain until more advanced medical care arrives. There are few things as stressful as having an infant who is not breathing and not knowing what to do. By learning and applying these a simple techniques you could save a child's life.
How Do You Know if You Should Administer CPR to an Infant?
You would administer CPR if an infant is unresponsive and not breathing. They may be blue around their mouth which indicates a lack of oxygen. To check if they are responsive, tap the infant gently on their feet, shoulders or chest and talk loudly to them. Under normal circumstances the child would stir or cry. If there is no response, you need to check their airway and find out if they are breathing at all. You do this by the Look, Listen and Feel method. Lie the infant down on their back and gently tip their head backwards, then looking towards their chest place your cheek directly above the infant's mouth. In doing this you can see if their chest is rising and falling - Look. You can listen for breathing as your ear will be close to their mouth and nose - Listen. And because the skin on your cheek is very sensitive you will be able to feel a breath on your cheek even if it is shallow - Feel. If none of these methods show evidence of breathing start CPR immediately. This assessment should take you less than ten seconds. Remember the sooner you start CPR on a casualty, the greater their chances of survival.
How do You Go about CPR?
Having completed your assessment, the infant should already be lying on their back with their head tilted back. Support the head by placing one hand on the forehead - this will help keep the airway open. Then place your mouth over both the infant's nose and mouth creating a seal. Take two gentle breaths, letting the infant breath out on their own. Watch the chest rise and fall so that you know the air is going into the lungs. Next place two fingers on the sternum (chest bone) directly in line with the nipples. By pressing down firmly with your two fingers give thirty short chest compressions. The movements should be smooth and regular, avoid a jerking motion or using too much force. Repeat this process for at least two minutes, alternating two breaths and thirty compressions. If possible call for help, but don't stop the cycle. After some time the infant may cough and start to breathe on his / her own. Once this happens you can stop CPR but you must continue to monitor them closely as they could stop breathing again.
Reasons Why an Infant May Not Be Breathing
When you come upon a scene where an infant is not breathing, take a very quick look at the surroundings. There could be obvious clues as to why this has happened. If a child has slipped into a pool or bath they have likely inhaled water. If there is a plastic bag nearby perhaps the infant got entangled and they began to suffocate. If there are toys lying around the child may have swallowed one and it's blocking their airway, or they may be choking on a piece of food. If the airway is blocked you need to first remove the obstruction before administering CPR otherwise it will be ineffective. Sometimes the child will be coughing, don't try to stop this, coughing is the most effective way to dislodge an object. If they are not responsive and you suspect a blocked airway then you need to first try to remove the blockage. To do this turn the infant face down resting on your knee or forearm supporting their head with your fingers. Then with the other hand give five short blows to the infant's back directly between the shoulder blades. Use the palm of your hand and strike in a downward motion. Turn the infant over and sweep their mouth with two fingers to see if you can find the object. If unsuccessful and you still suspect a blockage, repeat the process. Once the blockage is cleared, if the infant does not start to breathe on their own, begin CPR immediately.
Other Considerations for Infant CPR
If you are alone in the situation, start the assessment and CPR immediately, and continue for at least two minutes before calling for help. You don't know how long the child has been there and it's important to get air into their lungs as soon as possible. If there is someone else around, tell them to immediately call 911 while you start CPR. Seeing an infant lying lifeless can be very traumatic, and some people react in shock, going hysterical. If possible try to remove any hysterical person from the situation by asking someone to take them away and sit with them. Your focus should remain on performing CPR on the infant; don't allow yourself to be distracted. Once advanced medical care arrives, the paramedics or doctor will take over treatment. Stay around, as they will probably want to ask questions relating to the infant's condition when you found them and how long you performed CPR. This will give them an indication as to the best treatment for the child as well as other possible complications they should look out for.
CPR is a simple and very effective lifesaving technique. Make sure you are familiar with the procedure as you never know when you may need to use it. To further hone your skills attend a course where you can practice on dummies. You can also teach your friends and family.
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