Rescue breathing and chest compressions - infant; Resuscitation - cardiopulmonary - infant; Cardiopulmonary resuscitation - infant
CPR stands for cardiopulmonary resuscitation. It is a lifesaving procedure that is done when a baby's breathing or heartbeat has stopped. This may happen after drowning, suffocation, choking, or other injuries. CPR involves:
Permanent brain damage or death can occur within minutes if a baby's blood flow stops. Therefore, you must continue these procedures until the infant'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, reversing long-standing practice.
All parents and those who take care of children should learn infant and child CPR. See www.heart.org for classes near you. The procedures described here are NOT a substitute for CPR training.
Time is very important when dealing with an unconscious baby who is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur as soon as 4 to 6 minutes later.
Machines called automated external defibrillators (AEDs) can be found in many public places, and are available for home use. These machines have pads or paddles to place on the chest during a life-threatening emergency. They 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. Make sure the AED can be used on infants. When using an AED, follow the instructions exactly.
There are many things that cause an infant's heartbeat and breathing to stop. Some reasons you may need to do CPR on an infant include:
CPR should be done if the infant has the following symptoms:
1. Check for alertness. Tap the bottom of the infant's foot. See if the infant moves or makes a noise. Shout, "Are you OK"? Never shake an infant.
2. If there is no response, shout for help. Tell someone to call 911 or the local emergency number and get an AED, if available. Do not leave the infant yourself to call 911 or the local emergency number until you have done CPR for about 2 minutes.
3. Carefully place the infant on its 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.
4. Perform chest compressions:
5. Open the airway. Lift up the chin with one hand. At the same time, tilt the head by pushing 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:
8. After about 2 minutes of CPR, if the infant still does not have normal breathing, coughing, or any movement, leave the infant if you are alone and call 911 or the local emergency number. If an AED for children is available, use it now.
9. Repeat rescue breathing and chest compressions until the infant recovers or help arrives. Infants and children undergoing CPR should receive two breaths after every 30 chest compressions if there is a single rescuer. If there are two rescuers, the child should receive the two breaths after every 15 chest compressions.
Keep rechecking for breathing until help arrives.
Avoid making the situation worse by following these tips:
Steps to take if you are with another person or if you are alone with an infant:
Most children need CPR because of a preventable accident. The following tips may help prevent some accidents in children:
American Heart Association website. Highlights of the 2020 American Heart Association Guidelines for CPR and ECC. cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf. Accessed April 20, 2021.
Duff JP, Topjian A, Berg MD, et al. 2018 American Heart Association focused update on pediatric advanced life support: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2018;138(23):e731-e739. PMID: 30571264 pubmed.ncbi.nlm.nih.gov/30571264/.
Easter JS, Scott HF. Pediatric resuscitation. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 163.
Kearney RD, Lo MD. Neonatal resuscitation. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 164.
Rose E. Pediatric respiratory emergencies: upper airway obstruction and infections. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 167.
Topjian AA, Raymond TT, Atkins D, et al; Pediatric basic and advanced life support collaborators. Part 4: pediatric basic and advanced life support: 2020 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16_suppl_2):S469-S523. PMID: 33081526 pubmed.ncbi.nlm.nih.gov/33081526/.BACK TO TOP
Review Date: 2/12/2021
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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