Administering CPR to a Child
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.
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 can not 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 (For a child younger than 1 year, see Administering CPR To An Infant ):
- 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.
- 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.
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, begin rescue breathing.
- Perform rescue breathing.
If the child is not 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 deep breath and then place your mouth over the child's mouth, making a tight seal. Give two slow breaths (each about one and one-half to two seconds long) and repeat for two to five breaths. Watch for the child's chest to rise with each breath, and end the breath once you see the chest rise. 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.
- Check for signs of circulation.
Signs of circulation include normal breathing, coughing or movement. (Health care professionals should check for a pulse on the carotid artery in the neck, placing two or three fingers on the child's Adam's apple (voice box) and then sliding the fingers to either side, in the groove between the Adam's apple and the neck muscle.) If there are signs of circulation but the child is not breathing, continue rescue breathing — one breath every five seconds. If there is no sign of circulation, begin chest compressions.
- Compress the chest.
Place the heel of 1 hand on the lower half of the breastbone, about half an inch below the nipples but above the bottom of the breastbone. (Your other hand should be pressing down on the child's forehead to make sure the airway remains open.) Push in a downward motion toward the child's back approximately one-third to one-half the depth of the chest (about 1 to 1 1/2 inches). You should compress at a rate of at least 100 times per minute (or about 5 compressions every 3 seconds) in a smooth fashion. After every 30 compressions, give the child 2 rescue breaths.
- Repeat 5 compressions and 1 breath.
Give 1 rescue breath after every 5 chest compressions. Count out loud as you do this: "One, 2, 3, 4, 5 ... 30, breathe."
- Call for help after 1 minute.
If you are alone and cannot send another person for help, perform CPR for about 2 minutes (5 cycles of 30 compressions and 2 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 chest compressions and rescue breathing. If circulation has returned but there is no breathing, continue rescue breathing with 1 breath every 3 seconds (20 breaths per minute). Continue to monitor circulation and the breathing until emergency personnel arrive.