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In this lesson, we're going to cover infant rescue breathing for the healthcare provider. Our scene is safe, our gloves are on, our rescue mask is available with a one-way valve, and we're going to assess our infant. We tap on their feet. We rub their belly. We tap on their shoulder. Hey baby, are you alright? Are you okay? As soon as we establish that they're not responsive, we're gonna go ahead and activate EMS, call 911, or activate a code. Now, we're going to go ahead and look for normal breathing as we check for a brachial pulse for no more than ten seconds. As we check for this brachial pulse, if it's lower than 60 beats per minute we're going to begin CPR. If it's above 60 beats per minute we're going to go ahead and establish that the baby has a pulse but is not breathing. We're then going to cover the mouth and nose of the baby with the infant-size rescue mask and deliver one rescue breath every two to three seconds for two minutes. We check as we give a breath for chest rise and fall and we see it goes in and comes back out. Now we deliver only enough breath that we actually see the chest rise and then we don't force more in. It's important to know that we're moderating how much air we put in just to elicit that chest rise and fall. One one thousand. Two one thousand. One one thousand. Two one thousand. One one thousand. Two one thousand. Now an important thing to note here is that we as adults don't usually breathe at one breath every two to three seconds unless we're exercising and we could become hyperventilated. So what I like to do is take a deeper breath, hold it, and deliver about three or five or six different rescue breaths for my one breath, especially if I start to feel like I might be hyperventilating. So we're gonna continue this for two minutes, recheck for brachial pulse. If there is still a brachial pulse but no breathing, we continue with rescue breathing. If there's no pulse, or a slow pulse below 60, we're going to go into full CPR until the baby responds and begins breathing normally, help arrives, or an AED is available.
This lesson focuses on how to perform rescue breathing on an unconscious infant for the healthcare provider. And there are a few differences between adult/child rescue breathing and delivering rescue breaths to an infant that we'll highlight below.
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 infant-sized rescue mask with a one-way valve handy and begin calling out to the infant to assess whether or not he or she is responsive.
Are you OK? Can you hear me? (With infants, shouting their name, if you know it, may help.)
If you don't get an initial response and you can see that the infant still isn't breathing normally, place your hand on his or her forehead and tap on the bottom of the baby's feet, shoulder, or rub their belly. If you still do not get a response, proceed with the following steps.
Pro Tip #1: Notice that with infants, we check for a pulse using the brachial artery rather than the carotid artery. Also, keep in mind that a weak pulse can be considered the same as no pulse in infants. The dividing line is 60 beats per minute. If lower, begin CPR immediately. If above, establish that the infant isn't breathing normally, then begin rescue breathing.
Pro Tip #2: What does slightly sniffing look like? Imagine you've just walked into a kitchen and caught the whiff of a freshly baked apple pie. You turn your head upward ever so slightly to catch a better smell. Ever so slightly, or neutral, is our goal when delivering rescue breaths to infants.
The sequence for infants is the same as the sequence for children – 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.
Warning: As an infant's lungs are considerably smaller than the lungs of adults and even children, be careful not to force air in beyond the full point. To do this, watch closely as you deliver rescue breaths and stop when the chest reaches its apex.
Continue using the rescue breathing technique until help arrives or the patient revives. If you have an AED, consider preparing it for use just in case the patient loses his or her pulse.
Pro Tip #3: As adults don't normally breathe one breath every two to three seconds, there's a chance you may become hyperventilated while doing rescue breathing. To combat this, take in a deep breath, hold it, and use that air to deliver a few rescue breaths. This is especially important if you feel like you're about to begin hyperventilating.
Remember, if at any point you discover that the patient's pulse has disappeared, go immediately into full CPR and use an AED if you have one available.
It's really important to quickly recognize breathing emergencies in children and infants and to provide treatment before their hearts stop beating. In adults, when their hearts stop beating, it's typically because of a disease.
However, in children and infants, their hearts are usually healthy. Which is why when a child's or an infant's heart stops beating, it's usually the result of a breathing emergency.
When helping a child with respiratory problems, keep in mind that a lower airway disease may be caused by birth problems or infections such as bronchiolitis, bronchospasms, pneumonia, or croup.
Several of the illnesses and diseases that affect respiratory systems in infants and children are preventable through vaccines. These include:
Some diseases that may not have respiratory symptoms might still be spread through respiratory transmissions, such as mumps and severe diarrhea.