CPR and AED

Infant CPR

The small size of the infant casualty requires that CPR be adapted to their smaller form. Infants are more likely to experience breathing emergencies than cardiac situations; however, prolonged respiratory arrest will lead to cardiac arrest.

Performing One-Rescuer Infant CPR

To perform one-rescuer infant CPR, perform the following steps:

1. Perform a scene survey.
   1. Assess responsiveness.
   2. Send someone to call 9-1-1 and get an AED if available.
2. Perform a primary survey:
   1. Open the airway.
   2. Check for breathing for at least 5 and no more than 10 seconds.
      
      
   3. If the casualty is not breathing, or not breathing effectively (agonal breaths), begin compressions immediately.
3. Give 30 compressions. Push hard. Push fast.
   1. Position two fingers in the centre of the chest, just below the nipple line.
      
   2. Place your other hand behind your back, or on the ground above the infant’s head.
   3. Press straight down on the breastbone. The depth of each compression should be 1/3 the depth of the chest.
   4. Release pressure and completely remove your weight at the top of each compression to allow the chest to return to the resting position.
   5. Give compressions at a rate of 100 to 120 per minute. Count compressions out loud to keep track of how many you have given, and to help keep a steady rhythm.
4. Open their airway using a head-tilt/chin-lift.
5. Position a barrier device and give 2 ventilations.
   1. For an infant casualty, seal the mouth and nose.
   2. The amount of air delivered is very small compared to an adult or child. This amount of air is often described as a “cheek-full” of air.

This is one cycle of 30:2 (30 compressions to 2 ventilations).

6. Continue CPR until:

• An AED is applied.
• The casualty begins to respond.
• Another first aider or medical help takes over.
• You are too exhausted to continue.

An AED should be applied as soon as it arrives at the scene.

The back of an infant’s head is quite large compared to the rest of the body, and this can cause the infant’s head to flex forward while lying on their back and cut off their airway. When giving CPR, it may be helpful to put a thin pad under the shoulders to help keep the airway open, but do not spend too much time looking for a pad.

Performing Two-Rescuer Infant CPR

To perform two-rescuer CPR on an infant, the first aider who performs the primary survey stays at the casualty’s head, keeping the airway open and ventilating after 15 compressions. The second rescuer will compress the chest.

One cycle of two-rescuer CPR for an infant is 15 compressions and 2 breaths.

To maintain effective compressions, it is recommended that rescuers switch roles after every 10 cycles of compressions and ventilations (approximately 2 minutes).

When performing two-rescuer CPR on an infant, you can use the thumb-encircling method instead of two fingers if it is easier for positioning.