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Now let's cover rescue breathing for the child, for the healthcare provider. So we've had this victim pulled out of the water. They are potentially a drowning victim but we need to assess them to know, do we give them full CPR or just rescue breathing? The scene is safe. My gloves are on. My CPR shield is available. It's important to note that sometimes we have different size options available when it comes to giving rescue breaths with a one way valve barrier. This is for infants. This is for a child and an adult. So I'm going to place a hand on the forehead and tap on the collar bone. Are you all right? Are you okay? They don't respond to my taps and shouts. You in the plaid shirt, go call 911 and come back. I might need your help. And bring an AED. If I have my cell phone, I dial 911 and put it on speakerphone so I can talk to the dispatcher. But now I'm going to assess the patient for their needs. Head tilt, chin lift and as I am watching for normal breathing, listening for normal breathing, I'm going to feel for a carotid pulse check. Between the trachea and the sternocleidomastoid muscle on the outside, there is a valley. This valley is where the carotid pulse lies. I'm going to put my fingers on their windpipe and walk them into the first valley I find and feel with the flat part of my two fingers with moderate pressure for no more than ten seconds. Now in this case, I feel a nice, fast pulse. But the patient is not breathing normally. They may be bluish, blue around the lips, but they're not gasping. They're not doing this agonal respiration. They're not breathing at all. They're not responsive. But they have a pulse. So I'm going to go right into rescue breaths. One breath every two to three seconds for two minutes. I seal over the nose and mouth. I tilt the head back and I give rescue breaths. And I continue these rescue breaths for two minutes. After two minutes I reassess for a carotid pulse. If it's still there but there's no breathing I continue rescue breathing. If I check for a pulse and there's no pulse and no breathing, I go straight into full CPR.
This lesson focuses on how to perform rescue breathing on an unconscious child for the healthcare provider. As you'll soon see, there's one important distinction compared with rescue breathing for adults.
As you learned in the last lesson, what you find during your patient assessment will determine whether you'll perform full CPR or only rescue breathing. During your assessment, use your eyes and ears – is the chest rising and falling? Is the patient making any sounds that may indicate normal breathing? Is the patient showing signs of oxygen deprivation, like blue around the lips?
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive.
Are you OK? Can you hear me?
Pro Tip #1: There are two different sizes of rescue masks with one-way valves. There's an adult/child size and an infant size. You should always carry both, but if you don't and the mask you do have is too big, try turning it upside down. What you're aiming for is a good seal over both the nose and mouth.
If you don't get an initial response, place your hand on the child's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps.
Pro Tip #2: So, you know that agonal respiration isn't normal breathing. But do you know what it looks like? Have you ever seen a fish out of water gasping for air? It's similar to that. However, the important thing to remember is that while it really does look like breathing, it really isn't.
Pro Tip #3: The sequence has changed. With children, you're going to perform one rescue breath every two to three seconds for two minutes. At that time, reassess the patient. If you still detect a pulse but the patient isn't breathing normally, continue with one rescue breath every two to three seconds for two more minutes. And so on.
Remember to make sure the patient's chest rises as you perform your rescue breaths. If it doesn't, this could indicate an airway obstruction.
Remember, if at any point you discover that the patient's pulse is gone, go immediately into full CPR and use an AED if you have one available.
Identifying a respiratory emergency quickly and providing high-quality care is essential, as we humans cannot survive long without oxygen.
The human brain is quick to be impacted by oxygen deprivation. After 4-6 minutes, brain damage is possible. Between 6-10 minutes, brain damage is likely. And after 10 minutes, it's all but certain.
Reasons for breathing difficulties are numerous and include:
There are two types of respiratory emergencies – respiratory distress and respiratory arrest. During respiratory distress, breathing is difficult, labored, and/or restricted in some way. During respiratory arrest, breathing stops entirely.
Respiratory distress is often a sign of more serious health conditions and should be taken seriously. As for the causes of respiratory distress, they include:
When assessing a patient for respiratory distress, listen, watch, and ask.
Does their breathing look and sound labored? And how does the patient feel? Ask them to see if the optics are as bad as their symptoms. And as for the signs and symptoms of respiratory distress, they include: