Administering CPR to an Infant
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, accidents or drowning.
To enroll in a CPR course, contact your local office of the American Red Cross or American Heart Association. While this article cannot take the place of a CPR course, here is an overview of the basic steps in performing CPR on 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 baby
Place the baby on his back on a flat surface such as a table or the floor; otherwise hold the baby over your thigh. If the child has injured himself, be careful when moving him. It is always best to support the head and neck.
- Open the airway
Place one hand on the infant'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; an infant's head should not be tilted as much as an adult's.
- Perform rescue breathing
If the infant is not breathing, keep the head tilted. Take a deep breath then place your mouth over the baby's nose and mouth, making a tight seal, and give two slow breaths (each about one and one-half to two seconds long). Repeat for two to five breaths. Watch for the baby'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 baby's airway is open, and again try to give a breath. If the chest still does not rise, the infant may be choking.
- Check for signs of circulation
Signs of circulation include normal breathing, coughing or movement. (Health-care providers should check for a pulse on the brachial artery, inside of the upper arm about halfway between the elbow and the shoulder.) If there are signs of circulation, but the infant is not breathing, continue rescue breathing — one breath every three seconds. If there is no sign of circulation, begin chest compressions.
- Compress the chest
Wrap your hands around the infant's chest, with your thumbs over the breastbone, about one-half inch below the nipples. Compress the chest with your thumbs using your hands as a firm surface to push against. If the baby is lying on a firm surface, place the middle and ring fingers of one hand on the lower half of the breastbone, about half an inch below the nipples. (Your other hand should be pressing down on the baby's forehead to make sure the airway remains open.) With either technique, push in a downward motion toward the baby's back approximately one-third to one-half the depth of the chest (about one-half to 1 inch). 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 baby 2 rescue breaths.
- Repeat 30 compressions and 2 breaths
Give 2 rescue breaths after every 30 compressions. Count out loud as you do this: "1, 2, 3, 4, 5, etc., breathe."
- Call for help after 2 minutes
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). 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 minute or so, 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 with one breath every three seconds (20 breaths per minute). Continue to monitor circulation and breathing until emergency personnel arrive.