CPR Modification for Infants (Birth to 12 months) CPR can also be used on infants, the steps and sequence remain the same as for adults, however you must compensate for the smaller lung capacity and faster breathing rate of babies. Compressions are considerably less forceful than those used on adults. WARNING: Improper CPR or CPR performed on a infant whose heart is still beating can cause serious injury. Never perform CPR unless: * The infant has stopped breathing . * The infant 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 first aid organizations in your area; bring a friend with you! 1. Establish unresponsiveness and call for help. Tap the infant and gently shake the shoulder while you cry out for help. When help comes, send that person to call 911 or your local emergency number and ask for an ambulance. Place the baby on a firm horizontal surface. A table is best if one is handy, otherwise use the floor. If the baby is on his stomach, roll him over onto his back. Roll head, neck, and shoulders together as a unit. Caution: If there is trauma involved, the infant may have suffered a spinal injury be careful not to flex or twist the neck. 2. Check for breathing. Put your cheek over the infant's mouth and look, listen, and feel for air passing through the lips and for the chest or abdomen to move. This should take 3 to 5 seconds. Also check the lip color. If the lips are pink and you can hear or see the infant struggling to breathe, maintain an open airway, but don't start rescue breathing. If the lips are blue, not enough oxygen is reaching the blood and you must proceed to open the airway. 3. Open the airway. With one hand on the forehead and the other under the neck, tip the head back to open the airway, but don't extend it as far as you would with an adult. Because an infant's neck is very flexible, be careful not to tilt the head so far back that the airway is blocked or the spine damaged. 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 infant breathing again. Again, look, listen, and feel for signs of breathing (3 to 5 seconds). If the infant does not promptly begin breathing on his own, begin rescue breathing immediately. 4. Begin basic rescue breathing. Cover and seal both the infant's nose and mouth with your mouth and give a slow, gentle puff of breath. Too much air may distend the stomach and result in vomiting. Each breath should last 1½ to 2 second. Remove your mouth and allow time for the infant to exhale normally before delivering the second breath. Once you deliver 2 breaths and see a good chest rise, check the infant's pulse. 5. Check for pulse. Since the carotid pulse is difficult to locate on infants, use the brachial artery on the inside of the arm, midway between the elbow and the shoulder. Use the tips of your index and middle fingers. 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 if there is a pulse. Give one gentle puff of breath every 3 seconds. Check the pulse once per minute (every 20 breaths). Continue rescue breathing until the baby 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 your middle and ring finger on the sternum (breastbone) one finger width below the nipple line and depress no more than ½ to 1 inch. To get the proper speed and rhythm, count out loud as you do the compressions: 1,2,3,4,5. Don't lift your fingers from the baby's chest during the relaxation. Since the respiration rates of infants is faster than adults, the compressions should be at a rate of at least 100 a minute, rather than the adult rate of 80. Give 1 gentle breath every 5 compressions. Go back to the chest, find the correct finger 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 infant 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.