Compression For Infant CPR

Chest compressions

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In modern CPR, chest compressions are the most important and early step before securing a patent’s airway for breathing or establishing a heartbeat. This is done with two fingers placed on the lower third (not the end) of the sternum, marked by the location just below the baby’s nipples. The infant’s head is tilted back gently with the other hand. The chest is compressed to a third or a half of the way down to the spine behind 30 times in quick succession, only allowing the chest to rise completely in between two compressions.

For slightly older or bigger babies, the heel of the hand is preferred to allow sufficient compression. Sometimes, both hands are interlocked to give more force during CPR administration.

The hands are positioned vertically over the sternum. The point of compression should be the breastbone, about an inch above the bottom to avoid compressing the stomach. The fingers should not be included in the pressure to avoid injuries to the ribs.  

Rescue breathing (mouth-to-mouth resuscitation)

At the end of 30 compressions, the bony chin is elevated using a hand, while the head is tilted up with a hand on the forehead to straighten the airway. It is important to note that the CPR provider avoids pressing the soft tissue behind the bone, which can block the mouth or cause the mouth to close.

The child is observed for any evidence of breathing for about 10 seconds. Placing the ear near the infant’s nose and mouth to look for any chest movement and placing the cheek near the infant’s mouth and nose to check for breathing are commonly taught methods. It is important to note that irregular gasps are not normal breathing.

If no breath is felt or seen, the mouth and nose are checked for obvious blockage. Afterward, the nose is closed and the mouth is covered by the performer’s mouth to make a seal. Five rescue breaths are given over one second each that are adequate to produce a rise in the chest. This is followed by chest compressions again.

If there is no sign of recovery after two minutes of this combined procedure, calling an emergency number is necessary.

The procedure is continued until medical help arrives, or the baby begins to breathe spontaneously. Every few minutes, the breathing is checked after stopping the procedure. Once the infant coughs, breathes or moves normally, CPR must be stopped immediately. The baby is then turned on to the side if possible and normal breathing is rechecked.

Rate Of Compression For Infant CPR

Before starting baby CPR: danger, response, send for help

Check around you for danger. Remove baby and yourself from any danger.

Check baby for a response. Ask baby to open their eyes. Squeeze their shoulders.

Send for help
If baby is unconscious, not responding or breathing abnormally, call 000 for an ambulance.

Next steps: airway, breathing

Check baby’s mouth for airway blockages like the tongue, food, vomit or blood. If there’s a blockage, use your little finger to clear it. Place baby on their back with their head in a neutral position (head straight, chin not bent down or up) to open their airway.

If there are no blockages or you’ve cleared blockages, check for breathing. Look for chest movements, listen for breathing sounds, or feel for breath on your cheek.

Baby breathing normally? Place baby in the recovery position on their side with their head tilted down. Check baby regularly for breathing and responses until the ambulance arrives.

Baby not breathing?
 Baby not responding or baby breathing abnormally? Start CPR.

Start baby CPR

Put two fingers in the centre of baby’s chest. Do 30 compressions at a rate of 2 compressions per second. Each compression should push the chest down by about one third.

Hold baby’s head so that their chin doesn’t drop down. Take a breath and seal baby’s mouth and nose with your mouth. Blow gently and watch for the chest to rise. Take another breath with your head turned towards baby’s chest. Watch, listen or feel for air leaving the chest. Repeat.

Keep giving 30 compressions followed by 2 breaths until medical help arrives. If baby starts breathing normally and responding, put baby into the recovery position. Keep watching baby’s breathing. Be ready to start CPR again at any time.

What is the recommended compression-ventilation ratio for 1-rescuer infant cpr

Here is the latest CPR compression rate chart for Adults, children, and infants. You can download and print a copy by clicking the chart below. It includes the latest American Heart Association guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care for the depth and rate of compressions per minute, ventilations, rate of rescue breathing, and more.

CPR Ratios for Adults

High-quality CPR must meet certain metrics by the American Heart Association for improving survival from cardiac arrest. This includes providing chest compressions at the proper rate and depth. Here is the CPR ratio that you must remember when performing CPR for Adults. 

Compression to Ventilation Ratio

Compression to Ventilation Ratio refers to the number of chest compressions given, followed by the number of ventilation breaths given while performing CPR. According to the American Heart Association, the correct compression to ventilation ratio for adults is 30:2. It means to provide 2 ventilation breaths after 30 compressions and maintain a steady rhythm. If there is another rescuer, the same method must be followed, except that each person can take turns performing the ventilation breaths and the compressions without pausing either.

American Heart Association guidelines also indicate that in patients with an advanced airway, one ventilation breath every six seconds should be given with continuous chest compression instead of 30 compressions and two breaths. 

Rate of Compressions

This refers to the speed or rate of chest compression per minute when doing CPR. For example, a chest compression rate of 100 per minute means you can give 100 compressions in 1 minute if there’s no need for you to stop to provide ventilations. Usually, a single rescuer performing 100/1 continuous chest compression will perform about 75 chest compressions per minute due to the need for ventilation breathing. You will only do chest compressions without stopping until emergency medical personnel takes over if the victim were intubated. 

Depth of Compressions

Depth of compression is how far down the victim’s chest is compressed with each chest compression. According to the American Heart Association guidelines, the compression depth for adults is at least 2 inches or 5 cm, with a compression rate of 100-120 per minute.

Rescue Breathing

Rescue breathing is the number of ventilation breaths that are given each minute. Each rescue breath should be given over 1 second with a sufficient tidal volume to produce chest rise. This is for victims who still have a pulse but are not breathing. The first aider can supply enough oxygen to preserve life by rescue breathing into the victim’s lungs. It’s important to act quickly because brain damage can occur after only 3 minutes without oxygen. In a previous study of adults with out-of-hospital cardiac arrest, continuous chest compressions without rescue breathing did not result in significantly higher rates of survival than 30 compressions to 2 ventilations.

If an Automated External Defibrillator or AED is available, alternate 3-4 shocks with a minute of CPR. CPR should be continued until you see the patient breathing or regaining consciousness.  

CPR Ratios for Children

Adults usually require CPR due to sudden cardiac arrest resulting from a heart attack, while children tend to require CPR due to respiratory issue that leads to cardiac arrest. It’s essential that you know the proper CPR procedure and CPR ratio for children to be prepared when an emergency occurs. 

Compression to Ventilation Ratio

According to the American Heart Association guidelines, the compression to ventilation ratio for children is 30:2, which is the same for adults. This means you need to perform 30 chest compressions followed by two rescue breaths. If there are two rescuers, the compression to ventilation ratio will be 15:2.

Rate of Compressions

The recommended compression rate for performing chest compressions for children is at least 100 to 120 compressions per minute. After 30 compressions, tilt the head, lift the chin, and give two effective breaths. Although the rate of compressions will be 100-120 a minute, the actual number delivered will be fewer because of the pauses to give breaths.

Depth of Compressions

According to the American Heart Association guidelines, the depth of chest compression ratio for children is at least one-third of the diameter of the chest, which is about 2 inches or 5cm, with a compression rate of 100-120 per minute.

Rescue Breathing

To do rescue breathing for a child, put one hand on the forehead, and push with your palm to tilt the head back. Then, take a normal breath, and blow it to the mouth of the child for 1 second. Watch to see if the child’s chest rises. Aim to give 12 to 20 rescue breaths per minute for a child that isn’t breathing. This is about one rescue breath every 3 to 5 seconds.

CPR Ratios for Infants

CPR is performed when an infant is unconscious, they’re unresponsive, or if they’re not breathing. CPR will keep the blood and oxygen moving through the infant’s body with proper chest compressions and rescue breathing until more advanced training can take over.

Compression to Ventilation Ratio

The compression to ventilation ratio for an infant child is the same as the ratio for adults and children, which is 30:2. This means you need to perform 30 chest compressions followed by two rescue breaths for infants. According to the American Heart Association and ILCOR, it is permitted to perform “hands-only” CPR on adults and older children. But for infants, it’s recommended to weave in the two breaths every 30 compressions.

Rate of Compressions

Chest compressions on an infant are different than chest compressions on adults or children. Because an infant is more fragile, the chest compressions should be performed with only two fingers, at the center of the chest, just below the nipples. Rescuers need to perform continuous compressions at 100-120 per minute.  Allow the chest to return to its normal position after each compression.

Depth of Compressions

Since infants are more fragile than children and adults, the compressions should be performed with only two fingers, at the center of the chest, just below the nipples. Do not compress over the xiphoid or ribs. Compression depth should be about an inch and a half deep.

Rescue Breathing

For infants, form a seal around both the mouth and nose when giving rescue breaths. Aim to provide 12 to 20 rescue breaths per minute for an infant that isn’t breathing. This is about one rescue breath every 3 to 5 seconds.

Learn CPR and Save a Life Today

According to statistical analysis, out of hospital cardiac arrest affects nearly 1000 Americans each day; when including in hospital cardiac arrest, more than 500,000 adults suffer cardiac arrest each year in the United States. For cardiac emergencies, it’s important for first aiders to do CPR as soon as possible to increase the chance of survival while waiting for the emergency medical services team.

Basic Life Support providers performing successful resuscitation contribute to the survival rates from hospital cardiac arrest. If most people know how to perform CPR and use an AED, we could decrease the number of deaths from sudden cardiac emergencies. At CPR Select, we want to help save lives by teaching you  CPR skills based on American Heart Association guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. You can save a life by learning how to do rescue breathing or CPR quickly and easily through one of our online classes. 

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