CPR Modification for Children (1 to 8 years) CPR can also be used on children, the steps and sequence remain the same as for adults, however you must compensate for the smaller lung capacity of children. Compressions are less forceful than those used on adults. WARNING: Improper CPR or CPR performed on a person whose heart is still beating can cause serious injury. Never perform CPR unless: * The child has stopped breathing. * The child has no heartbeat. * No one with more training in CPR is present at the incident. You should take a CPR course with the American Red Cross or one of the volunteer organizations in your area, take a friend with you! 1. Establish unresponsiveness and call for help. Shake the child gently on the shoulder and shout, "Hello, can your hear me, are you okay?" Be careful not to flex or twist the neck, as the child may have a spinal injury. Move the child only if necessary. If the child doesn't respond, call for help. (When help comes, send that person to call 911 or your local emergency number and ask for an ambulance.) If the child is lying on his stomach, gently support his neck and roll him over onto his back. Roll head, neck, and shoulders together as a unit. 2. Check for breathing. Kneel at right angles to the child's shoulder, and looking toward the child's chest, put your cheek next to his mouth to feel air passing through the lips. Watch the chest and abdomen to see if either is moving. In other words, look, listen, and feel for signs of breathing. This should take 3 to 5 seconds. If these signs aren't present, the child is not breathing and you should open the airway. 3. Open the airway. Open the airway by returning the child's head face up, tilting the forehead back with one hand while lifting up on the chin with the other hand (head tilt/chin lift). In an unconscious person the tongue relaxes and falls against the back of the throat, blocking air to the lungs. Sometimes, just opening the airway is enough to get the child breathing again. Again, look, listen, and feel for signs of breathing (3 to 5 seconds). If the child does not promptly begin breathing on his own, begin rescue breathing immediately. 4. Begin basic rescue breathing. Pinch the child's nostrils shut with your hand still on the forehead. With your other hand still holding the chin, place your mouth over the child's mouth, making a tight seal. Slowly blow air into the child's lungs until the chest rises. Each breath should last 1 to 1½ seconds. Remove your mouth and allow time for the child to exhale normally before delivering the second breath. Once you deliver 2 breaths and see a good chest rise, check the child's pulse. 5. Check for pulse. Locate the carotid artery in the neck. Place the tips of your index and middle fingers on the child's Adam's apple. Slide your fingers down the side of the child's neck that is facing you, into the groove under the Adam's apple. Hold your fingers in place for 5 to 10 seconds. 6. If pulse is present-rescue breathe only. If there is a pulse, continue rescue breathing only. Do not do chest compressions on someone who has a pulse. Gently blow into the lungs once every 4 seconds. Check the pulse once per minute (every 15 breaths). Continue rescue breathing until the child breathes on his own or until medical help arrives. A revived victim still needs to be seen by a Doctor. This is important because a person can easily go into shock after breathing has stopped. 7. If pulse is absent-perform chest compressions. Place heel of one hand over the lower half of the sternum (breastbone) 2 finger widths above the notch where the sternum and ribs meet. Use only one hand and be sure to use only the heel, keeping your fingers off the chest to avoid injuring the ribs. Straighten your arm and lock your elbow. Position your shoulders directly over your hand to make sure the thrust of each compression goes straight down on the sternum. Using a steady, firm thrust, push down hard enough to press the lower end of the sternum 1 to 1 ½ inches with each compression. Lift your weight from the child without lifting your hand from the chest. Repeat the compression. Use a rate of 100 compressions per minute. To get the proper speed and rhythm, count out loud as you do the compressions: 1, 2, 3, 4, 5. After 5 compressions perform 1 breath. Take your hand off the chest, open the airway as before (head tilt/chin lift), pinch the nostrils, seal the mouth, and give 1 breath. Looking out the corner of your eye, check for the chest to rise. Remember, the chest must deflate after each breath. Go back to the chest, find the correct hand position again, and do 5 more compressions, followed by 1 breath. Repeat this compression/breath ratio of 5:1 approximately 1 minute. Then check again for pulse and breathing (3 to 5 seconds). If neither has returned, you must continue compressions and breathing until the child revives, qualified help comes, or you become exhausted. Recheck pulse every few minutes. WARNING: This is not a replacement for a CPR course, improper CPR or CPR performed on a person whose heart is still beating can cause serious injury. Never perform CPR on a person with a pulse. Take a CPR course now! ------------------ These files may be accessed through the web at http://firstaid.ie.eu.org/ I would like to thank the IEASR for allowing me to convert their pages over to the Pilot. Gordon Thomas #admin@dogpatch.org (Remove the # character in order to e-mail.) http://www.dogpatch.org ------------------ DISCLAIMER: Information in these files is presented in order to impart general information relating to first aid of various injuries and conditions. Such information is not complete and should not be used as a substitute for a consultation or visit with your physician or other health care provider, or as a substiture for actual training in first aid and/or CPR. While all reasonable care has been taken in compiling this information, Mary Jo Sminkey and Irish Emergency Ambulance Services Resource (IEASR) make no warranty as to the information's completeness, reliability or accuracy. Access to and use of the information contained herein is entirely at the risk of the user, Mary Jo Sminkey and IEASR shall not be liable, directly or indirectly to the user or any third party for any damage resulting from the use of the information contained or implied in the Pilot First Aid files.