Written by Dr. Chetan Ginigeri
A parent or not; you will be surrounded by babies one way or another. Trust us, nobody has ‘perform cardiopulmonary resuscitation (CPR) on a baby’ written in their daily planner. But as we all know not everything can be pre-planned. Either your baby or your little cousin or a baby of your neighbor or a baby of a random stranger in a grocery shop might need your help breathing. Learning how to perform CPR in babies will help you save a life in unexpected times.
CPR is a process that includes chest compression and mouth-to-mouth resuscitation. Performing CPR can help save a baby’s life in case the heart stops beating. It is advised that parents, grandparents, teachers, or babysitters should know when and how to perform CPR in babies in the right way because, if done improperly, it can be very harmful. We have prepared a complete guide for you below that will answer all your queries about CPR for infants.
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The air that the lungs inhale contains oxygen and the heart supplies that oxygen along with the blood to various parts of the body. If the baby stops breathing or the heart stops beating then it can cut off the flow of oxygen to the vital organs. This can lead to brain damage within four minutes and/or even death in four to six minutes.
Unlike adults, CPR in babies is required in case of respiratory issues that can lead to cardiac arrest.
The reasons that can cause a baby’s heartbeat or breathing to stop include:
CPR is short of Cardiopulmonary Resuscitation. It is an emergency lifesaving technique used to keep the blood flowing through a person’s body when the heart stops beating. It involves chest compressions to keep the blood flow intact and rescue-breathing to provide oxygen to the lungs.
Time becomes a factor of big concern while you are dealing with an unconscious baby. CPR is most effective when performed at the earliest. Doing CPR in babies will help deliver oxygen to the brain until help comes or the baby recovers.
CPR is performed in adults and infants for the same reason – to help lung and heart work when they cannot. But there are certain differences that one should keep in mind while performing CPR on babies:
While checking for responsiveness, do not shake the baby as it may cause brain damage. You should call the baby loudly while tapping the soles of their feet.
In an infant, one should use a bilateral brachial artery to check the pulse. To do so press 2 to 3 fingers gently on the inner side of the upper arm for 5 to 10 seconds.
In an infant should be 1/3rd the depth of their chest or 1.5 inches.
Use the 2 finger technique. When there is only one rescuer present, use two fingers for chest compression. Place two fingers, just below the nipple line, in the center of the infant’s chest. Push the chest to the 1/3rd of the chest or one and a half inches. In between compression, allow the chest to regain its position. Perform the compression at the rate of 100-120 compression per minute.
If there are two rescuers, the compression to ventilation ratio becomes 15:2. Sit near the baby’s feet and place two thumbs side by side, just below the nipple line in the center of the chest. Encircle the chest in such a way that the fingers of both hands hold the back of the baby. Start the compression using thumbs at the rate of 100-120 compression per minute. The depth of compressions should be 1/3rd of the chest. This technique allows another rescuer to support breathing without coming in the way. This technique is preferred.
While performing CPR in a baby this should be 30:2 in the case of one rescuer. If there are two-rescuer you can give 15 compressions and 2 breaths.
Adults require CPR when they go into cardiac arrest. However, infants need CPR when they are in a respiratory problem before going into cardiac arrest. The aim is to not let the baby go into cardiac arrest. Cardiac arrest means the baby becomes suddenly unresponsive. Hence, if you did not see the baby go into cardiac arrest then first administer CPR for two minutes before calling emergency service. And if you see a baby go into cardiac arrest then first call emergency service and then start CPR again.
One should only perform CPR in infants only when they are either unresponsive, unconscious, not breathing normally or there are no signs of life.
We understand that as parents or caretakers you need to take urgent steps to make the baby responsive, but there are a few precautions & steps you need to take while giving a baby CPR:
Keep the following steps in mind if you are performing the Baby CPR alone:
1. Sit down beside the baby. Position the baby on its back.
2. Place two fingers in the center of the baby’s chest, below the nipple line. Give 30 compressions at the rate of 100 to 120 per minute. Count as you perform the compression. Depth of compression should be 1.5 inches deep or 1/3rd the depth of the chest. Remember Push hard – Push fast.
3. Open the airway by lifting the head slightly backward and lifting the chin. Remember not to tilt the head too far back.
4. Seal baby’s nose and mouth with your mouth and give two gentle breaths of one second long each. Make sure you see the baby’s chest rising after each breath. Do not force ventilation just gently, else it can cause lung damage.
5. Continue performing CPR in the same way – 30 compression 2 breaths – until you see signs of life or help arrives.
Performing CPR in a baby includes both chest compression and mouth-to-mouth ventilation (rescue breaths). CPR ratio gives infant CPR compression to ventilation rate. This shows for every breath how many compressions are required to optimize the flow of oxygenated blood through the cardiovascular system and to the brain.
When it comes to performing CPR for infants one cannot forget the CPR ratio. The CPR ratio for an infant is 30:2. That means to give 30 chest compressions followed by two rescue breaths.
If you are giving two-rescuer CPR (explained below) you can shift the ratio to 15:2.
One rescuer and two-rescuer CPR for infants simply indicates the number of rescuers who are available to perform CPR. If you are alone, perform the one rescuer for an infant. If there is another person with you or someone who comes to give help perform two-rescuer CPR for infants. The technique in two-rescuer CPR enables more steady compressions and blood flow as compared to one-rescuer CPR.
How to perform one rescuer and two-rescuer CPR is mentioned below.
If possible, read all the above information once again to not make any mistakes while you are in a life and death situation. Learning how to perform CPR on a baby is important as no one knows when this life-saving skill comes in handy. You can also get CPR training from certified classes as hands-on experience is always better.
Read Also: Epilepsy In Babies: Signs and Causes
Dr Chetan Ginigeri is an experienced Pediatric Intensivist with national and international training. With 15 years of experience, he is one among very few Intensivists in India trained to take care of children who need/had organ transplants. He has been responsible for coordinating the Pediatric Organ Transplant program.Read more.
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