CPR — cardiopulmonary resuscitation — is a basic lifesaving technique used when breathing stops and/or the heart no longer beats. In children, CPR is rarely needed for heart problems. More often it is needed for breathing problems due to choking, smoke inhalation, lung disease such as asthma, drowning or other accidents. CPR is most successful when started as quickly as possible, but only when it's necessary. It should only be performed when a child is not breathing or circulating blood adequately.
It is ideal for everyone to know how to perform CPR, when needed. To enroll in a CPR course, contact your local office of the American Red Cross or American Heart Association. While this cannot take the place of a CPR course, here is an overview of the basic steps in performing CPR on a child between 1 year and 8 years old.
- Assess and get help.
The first few seconds should be used to figure out whether the child is unresponsive. To do this, call out the child's name, clap, gently tap his shoulder, or rub his back or chest and watch for any reaction. If you get no response, shout for help and proceed to check for breathing. If you are not alone, have someone else dial 911.
- Position the child.
Place the child on his back on a flat surface such as the floor or a table. If the child has injured himself, be careful when moving him. Always support the head and neck.
- Compress the chest.
Place one hand over the other on the center of the chest, just below the nipples. Use the heel of one hand and push on the sternum, hard and fast in a downward motion toward the child's back. Each compression should be 1 ½ to 2 inches deep or about 1/3 to ½ the depth of the chest. You should compress at a rate of at least 100 times per minute (or about five compressions every three seconds) in a smooth, ongoing fashion. Do thirty chest compressions and let the chest rise completely each time. Proceed to opening the airway and rescue breathing after thirty chest compressions.
- Open the airway.
Place one hand on the child's forehead and the other under his chin. Slightly tilt the head back to open the airway by lifting the chin up and out while pushing down on the forehead. A child's head should not be tilted as much as an adult's.
- Check for breathing (in 10 seconds or less).
Turn your head toward the child's chest. Look for chest movement. Place your ear and cheek over the child's mouth to listen for or feel any breathing. Watch for chest wall movement.
If you can see, hear or feel the child breathing, help him maintain an open airway, but do not start breathing for him (rescue breathing).
If the child is not breathing, start rescue breathing
- Perform rescue breathing.
Pinch the child's nostrils closed with your thumb and forefinger while keeping pressure on the child's forehead with the same hand. Lift the chin with the other hand and keep the head tilted slightly. Take a breath and then place your mouth over the child's mouth, making a tight seal. Give one normal breath lasting about one second. Watch for the child's chest to rise. End the breath once you see the chest rise. Do a second breath.
If the chest does not rise, re-position the head to make sure the child's airway is open, and again try to give a breath. If the chest still does not rise, the child may be choking.
- Call for help after two minutes (if you can do this quickly).
If you are alone and cannot send another person for help, perform CPR for about two minutes (5 cycles of thirty compressions and two breaths each time). Then call 911 or your local emergency number. Resume CPR as soon as possible after calling for help.
- Check for return of breathing or signs of circulation.
Every few minutes, check for signs of circulation and breathing. If there is no sign of circulation, continue and repeat with 30 chest compressions and 2 rescue breaths. If circulation has returned but there is no breathing, continue rescue breathing with one breath every three seconds (20 breaths per minute). Continue to monitor circulation and the breathing until emergency personnel arrive.