Lay Person Cpr On Children

GENERAL INFORMATION:

What is lay person CPR for children?

• CPR is also called cardiopulmonary resuscitation. CPR is used when a person stops breathing and his heart has stopped beating. Child CPR should be used on children from about 1 to 8 years old. "Lay person" refers to anyone who is not a trained healthcare worker. If you start CPR early and do it correctly, you may be able to save someone from dying. Practice the steps of CPR and know them well.
  
  
• Rescue breathing means breathing into the mouth of a person who is unable to breathe well enough on their own. A chest compression is the placement of pressure on and off the chest with your hand or hands. A compression presses the heart between the spine (backbone) and sternum (breastbone). This forces blood out of the heart and into the rest of the body. Chest compressions done with rescue breathing is called CPR. An automatic external defibrillator (AED) is often found in public places such as airports, casinos, and shopping malls. The use of an AED device in addition to correctly doing CPR may help save a person's life.

Why might a child need CPR?

• Foreign body airway obstruction (an object stuck in the airway), suffocation, or strangulation.
  
  
• Injuries.
  
  
• Poisoning.
  
  
• Infection.
  
  
• Heart disease, brain disease or medical conditions that affect breathing.

What can I do to help prevent respiratory and cardiac arrest in children?

• Foreign body airway obstruction: Do not leave small objects around that your child can pick up and put in his mouth. Examples include batteries, coins, marbles, buttons, balloons and small toys or toy parts. A good rule is to not allow your child near anything small enough to fit through a toilet paper roll. Airway obstruction can also be caused by foods such as hot dogs, grapes, nuts, popcorn and hard candy.
  
  
• Suffocation: Do not leave plastic bags within reach of a child. Children tend to put plastic bags over their heads, making them unable to breathe.
  
  
• Strangulation: Keep drapery and extension cords out of the your child's reach. Do not put any type of cord or string around a child's neck. Some examples include cords or strings with pacifiers or jewelry attached to them.
  
  
• Drowning: Do not leave your child alone in or near water. This includes a pool, bathtub or pail of water.
  
  
• Car Safety:
  
  
  • Keep your child secured in a car safety seat while driving. Ask your caregiver for more information on car safety seats.
    
    
  • Never leave your child in a car alone, especially when the windows are rolled up.
    
    
  • Do not drive if you have been drinking alcohol, taken illegal drugs or medicines that make you sleepy.
  
  
• Falls: Do not leave your child alone on a high surface from which he may fall, such as a changing table. Use toddler gates at the top of stairs. Watch children while they play on playgrounds.
  
  
• Gun injuries: If you must keep guns in the house, store them out of your child's reach. All guns should have a safety lock on them, be locked up out of reach of your child, and be kept unloaded. Store and lock all bullets in a place out of reach, and different from where the gun is locked.
  
  
• Poisoning: Keep cleaning supplies and other harmful products out of your child's reach and locked up tightly.

What should I do if I find a child who may need help? When you find a child who is unresponsive (does not speak or move when spoken to), follow these steps:

• Make sure the area is safe to enter, and approach the child. Move the child only if the area is dangerous.
  
  
• Find out if the child is OK. Tap the child's shoulder. Ask loudly, "Are you OK?"
  
  
• If the child responds, call 911 immediately, send someone to call for help, or call from a cell phone. If you leave the child to call, return as soon as possible and stay with him until help arrives. Allow the child to sit or lie in a position that he chooses. Check often to see if the child is having trouble breathing or other problems.
  
  
• If the child does not respond and you are alone, shout loudly for help. Begin the steps of CPR and do them for about two minutes. Give two breaths followed immediately with 30 chest compressions. Do breaths followed by compressions five times. After about two minutes or five cycles, call 911 from a cell phone, or leave to call 911. If anyone is nearby, send them to call 911. If the child is not injured and he is light weight enough to carry, take the child with you to call 911. Stay on the telephone with the 911 operator until they tell you to hang up. Look quickly in the area for an AED device while calling 911. You may find an AED mounted on the wall in a glass-front box, with a sign stating that it is an AED. If an AED is found, quickly bring it back to the child who needs help.

How do I give CPR to a child? By following the "ABC's", you can remember the steps to use when giving CPR. The letter A stands for airway, B stands for breathing, and C stands for circulation.

• A irway:
  
  
  • Kneel beside the child and look at him to check if his head, neck, or back may be hurt. Carefully turn the child onto his back, while supporting his head and neck. Keep the child's body in a straight line (with no twisting) as you turn him onto his back. The child should be lying on a hard surface.
    
    
  • Open the airway by gently tilting the head back and lifting the chin. Look into the child's mouth and check if anything is blocking the airway, such as food or a small toy. If you see something that appears easy to grab, scoop it out with your finger.
  
  
• B reathing:
  
  
  • Check for breathing: Look, listen and feel for breathing while keeping the airway open. Look at the child's chest and abdomen (belly) to see if they go up and down with breathing. Listen near the child's nose and mouth for breath sounds. Feel for movement of air from the child's mouth by putting your face close to the child's face. Take only 10 seconds or less to check for breathing.
    
    
    • If the child is breathing on his own and there are no signs of head or neck injury, carefully turn the child on his side. Support the head and neck as you turn the child onto his side. Position his lower arm to rest in front of his body. This is called the recovery position. It may help to keep the child from choking if he throws up. If there are signs of head or neck injury, leave the child on his back. Hold the airway open by tilting his head and lifting his chin slightly. Wait for caregivers to arrive.
      
      
    
    
  • If the child is not breathing, you should begin CPR: Begin by giving two breaths to the child.
    
    
    • Keep the airway open by keeping the head slightly tilted and the chin lifted. Gently pinch the child's nose with the hand that is already on the child's forehead. Pinching the nose keeps air from escaping from it. Take a breath for yourself and place your lips over the mouth of the child making an airtight seal.
      
      
    • Give two breaths to the child (one second for each breath). Do not give very large breaths, or breathe hard or fast. Take a normal breath for yourself after giving each breath. If you do not see the child's chest rising with each breath, the airway may not be open. Gently move the child's head to open the airway and try to breathe for him again. If you still cannot get air into the child, the airway may be blocked by something such as food. Look into the child's mouth for something that may be blocking the airway. If you see something that would be easy to remove, carefully scoop it out with your finger.
      
      
    • If you carry a special mask or device for giving breaths during CPR and you have it with you, use it. If you do not have it with you, give rescue breaths without it.
  
  
• C irculation:
  
  
  • After giving rescue breaths, begin compressions immediately:
    
    
    • Hand position for chest compressions:
      
      
      • Kneeling beside the child, put the fingers of your hand on the child's lower rib cage on the side nearest you. Move your fingers up the child's rib cage to the place where the ribs meet in the middle of the chest. This area is called the sternum.
        
        
      • Chest compressions may be done in one of two different ways. Quickly decide the best way by comparing your body size with the size of the child. For a small child, use only one hand to do compressions. If the child is larger and you are smaller, chest compressions will be more effective if you use two hands.
        
        
        • One hand technique: Put the heel of one hand on the lower half of the sternum (at the nipple line).Keep your other hand on the child's forehead. Get up on your knees and position your body right over the child, not to the side. With the heel of your hand, press straight down on the child's chest, about one inch to one and one-half inches in depth. This should be about one-third to one-half of the depth of the child's chest. Keep your arm straight when doing chest compressions. Look down at your hand.
          
          
        • Two hand technique: Put the heel of one hand on the lower half of the sternum (at the nipple line) and place the heel of the other hand on top. Lace your fingers together or extend them above the chest. Lock your elbows with your arms straight. Your shoulders should be directly over the center of the child's chest. Press down on the sternum about one and one-half to two inches. This should be about one-third to one-half of the depth of the child's chest. Keep your arms straight when doing chest compressions. Look down at your hands.
      
      
    • The compressions should be constant and equal. This means that it should take the same amount of time to press down as it does to release the compression. Allow the chest to relax completely between compressions while leaving your hands on the chest in the correct hand position. This is necessary because it allows blood to come back into the heart before you compress again.
      
      
    • Do 30 chest compressions at a rate of about 100 every minute (almost two compressions per second). Push hard and push fast. Do not delay or stop the compressions. Count the compressions out loud if that will help you do them at a steady, even speed. Counting may also help you remember how many compressions you have done.
    
    
  
  
• Putting it all together:
  
  
  • After 30 compressions, quickly move up to the child's head. Open the airway by tilting the head and lifting the chin. Give two rescue breaths (about one second for each breath).
    
    
  • Give 30 compressions and two rescue breaths. Keep doing this until the child starts to move around, an AED is available, or caregivers arrive.
    
    
  • If the child begins to respond or move around, stop doing CPR. Carefully turn the child on his side if there are no signs of head or neck injury. Support the head and neck as you turn the child onto his side. Place his lower arm out in front of him in the recovery position. This position will help prevent choking if the child throws up. If there are signs of injury, leave the child on his back and hold the airway open. Stay with the child and watch him closely until caregivers arrive.
    
    
  • If an AED becomes available and the child is still unresponsive, stop doing CPR and quickly follow the directions for using the AED.

How do I use an automatic external defibrillator (AED)?

• An AED is a device that finds the heart rhythm of a person and tells you if the person needs a shock. The device will only deliver a shock if one is needed. After a shock is delivered, the heart may begin beating in a more normal pattern. Using an AED may help save a person's life.
  
  
• AED's give verbal directions and have pictures to help you use them. They are battery-operated, and have computers inside. The devices can be different sizes, colors and shapes, but are often light weight and about the size of a small kitchen appliance. The AED usually has a central device and two electrode pads. There may be step-by-step directions for how to use the device on or inside it. Follow those directions for using the device. The following are general directions for how to use an AED:
  
  
  • Remove all clothing from the child's chest.
    
    
  • Open the device. There may be a latch on one or both sides of the device to open it. Turn the device on with a button, switch or by other means. The on button or switch should be clearly marked. There may also be a button or switch that will change the device to be for a child instead of an adult. If this is available, change the AED to the child setting. If the child setting is not available, use the AED anyway.
    
    
  • Find the electrode pads. You may need to pull a handle or open or unwrap the pads. The pads may be attached to the device by thin wires. Do not detach the electrode pads from the device.
    
    
  • Electrode pads may have a sticky side that will stick to the child's chest. You may need to remove paper backing from the pads to expose the sticky side before they can be used.
    
    
  • The pads may have pictures on them to show you where to place them on the chest. The right pad should be placed on the right upper chest towards the middle, and below the clavicle (collar bone). The left pad should be placed on the left side of the chest, just below and to the side of the left breast. You may also place each pad on each side of the rib cage, just below and to the outside of the breasts.
    
    
  • If you see that the child has an implanted medical device, be sure the pad is placed at least one inch (2.5 centimeters) away from it. If you see a medicine patch anywhere on the skin, quickly remove the patch and wipe the area before placing the electrode pad. If the child is lying in water, quickly move him out of it before placing the electrode pads. If a child's chest is covered with water, liquid, or sweat, quickly wipe the chest dry before applying the electrode pads.
    
    
  • The AED will tell you if the child needs or does not need a shock, and will deliver one only if needed.
    
    
  • After a shock is delivered, the child's heart may take a minute or more to begin beating correctly. Because of this, begin the steps of CPR again. Give two rescue breaths followed by 30 compressions until the child starts to move around, or caregivers arrive.

When should I stop doing CPR on a child?

• When someone else that knows CPR or trained caregivers show up to take over for you.
  
  
• If you are exhausted and unable to continue.
  
  
• If the scene suddenly becomes unsafe, such as if a fire starts or spreads.
  
  
• When the child becomes responsive. He may move around or speak.

What else should I know about CPR and the AED?

• Do not delay giving CPR. When a child stops breathing, his heart may continue to beat for several minutes. After that, the heart will not beat, and brain damage is possible. Brain damage happens because there is no oxygen going to the brain. To avoid brain damage, and death in some cases, begin the steps of CPR right away.
  
  
• Do chest compressions. The risk of catching a disease or getting sick from giving rescue breaths is very low. If you are unable to, or don't want to give rescue breaths, do chest compressions. Chest compressions alone make it more likely that the child will live than if you do nothing at all.
  
  
• Use an AED if one is available. AED's are generally easy to use, a child will not be hurt by the AED, and they cost you nothing to use. The AED may save a child's life.
  
  
• When giving chest compressions, push hard and push fast. Hard, fast compressions are more likely to keep the child's brain and heart muscle alive. They also increase that chance that a shock delivered by the AED will make his heart beat correctly again.

Where can I get support and more information? To become a certified CPR provider, you must take classes through an organization like the ones listed below. Never practice CPR on another person if they do not need it. You can seriously hurt someone if you practice CPR on him. Never remove an AED from it's storage case unless you intend to use it. Contact the following for more information:

• American Red Cross National Headquarters
  2025 E Street NW
  Washington, DC 20006
  Phone: 1-202-303-4498
  Web Address: http://www.redcross.org
  

• American Heart Association National Center
  7272 Greenville Avenue
  Dallas, TX 75231-4596
  Phone: 1-800-242-8721
  Web Address: http://www.americanheart.org
  

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

Link to this page

Printable Version

Email Page