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Like all scenarios, we have to ensure that the scene is safe before we begin rescue, or else we can become a victim, too. And in this scenario, you can see that the baby has probably actually got themselves into a bad situation because they bit a cord that was frayed and may have been electrocuted. So, before we ever touch this baby, we've gotta make sure that we de-energize the source of the electrocution. In this case, I follow with my eyes the cord, right back to its source of energy, and I carefully unplug it and ensure that there's no longer any chance of getting electrocuted. It's at this time, if there are bystanders, it wouldn't be bad to call 9-1-1 or have somebody go call 9-1-1 while we then grab the baby and bring them to a place where there's a hard surface so that we begin rescue. Carefully roll the baby, bring them to a hard surface. Now, let's take a look at infant CPR. But, before we get into the actual skills, let's talk about a few important parts. And one of those is, make sure that the surface that you lay the baby on is hard and it will not allow the body of the baby to sink into padding, that's a part of the reason why I'm not on the floor on a carpeted, padded surface. We wanna make sure that every compression I give is maximal. We wanna make sure that it is actually doing what it's supposed to do and that the baby's body is not sinking into that surface, diminishing the effect of the compression. Number two, when it comes to infants and children, they're so respiratory-driven, they're so oxygen-driven that we wanna make sure to make a note whether or not they went into cardiac arrest in our presence or whether we found them already in cardiac arrest. Because if we found them in cardiac arrest and we don't know how long they've been down, we know they need oxygenation really bad. And so, we're gonna actually postpone contacting 9-1-1 or EMS to give them CPR when we don't have a phone readily available. If we have a phone available or we have somebody who can go call 9-1-1, then by all means, don't delay EMS. But, if you don't have a way to call 9-1-1 and we found the baby already in cardiac arrest, we're gonna deliver two minutes of CPR before we interrupt to go call 9-1-1. If the baby was witnessed, we call 9-1-1 immediately and then go right into CPR. It's not wrong to carry the baby with you, either. So, if you found the baby downstairs and you know you have to bring them up to meet the ambulance, you could carry the baby with you and get the 9-1-1 call made, and then begin your CPR right away. In this case, the scene is safe, our gloves are on, our CPR shield is available, and I actually do have a cellphone that's available. So, I'm gonna call 9-1-1 because the baby is not responding. I've already tapped their feet, I've already tapped their chest. They didn't move, they didn't cry, they didn't talk, they didn't move to my tickling, and they certainly are not breathing normally. So, I know this is a medical emergency, so I called 9-1-1, I actually put the phone on the speaker so that the dispatch center can coach me through this event. I'm not alone anymore, I have help. Now, I'm gonna bare the chest of the baby and I'm gonna find the imaginary line between the nipples. I'm now gonna begin my one-third the depth of the chest, or approximately one and a half deep compressions at a rate between 100 and 120 times per minute. 1 and 2 and 3 and 4 and 5 and 6 and 7 and 8 and 9 and 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30. Now, I'm gonna take my CPR shield with a one-way valve. I'm gonna cover the nose and mouth of the baby. Now, watch as I do the head tilt/chin lift. I'm not bringing the head fully back like I would a large child or an adult because a baby's airway is only the size of their pinky. So, what we're doing is bringing the baby's head into more of a neutral position. Remember, infants don't really have much of a neck, so if their chin is too close to their chest or their head is tilted back too far, both can actually diminish the openness of their airway. So, I want them in more of a neutral position. Now, there's another little way to remember that, and I call it the sniffing position. Now, what do I mean by sniffing position? Well, what I mean is, if you walked into a room and someone were baking cookies, you wouldn't really put your nose down like you were smelling a flower, you would maybe put it a slightly bit up into the air and, (sniffs) ooh, someone's baking cookies. What's that smell? So, that's what we mean by the sniffing position. It's not fully back, it's just slightly raised. And so, we bring the baby's head into the neutral position or slightly-sniffing position. Now, I'm gonna seal my mouth over the nose and mouth of the baby and deliver a rescue breath. As I deliver the breath, I see the chest rise and fall. I'm gonna deliver my second breath. As I give my second breath, the air goes in again. Now, we can also use the heel of one hand in the center of the chest for compressions. I'm gonna repeat the chest compressions. 30 chest compressions between a rate of 100 to 120 times a minute. Then, I'm gonna give them two more rescue breaths, and I'm gonna continue this cycle of 30 chest compressions to two rescue breaths and I'm not going to stop until EMS arrives, an AED arrives, or someone equally trained or higher relieves me.
Infant-related cardiac arrests are typically the result of:
Just as with child CPR, due to the nature of these occurrences, providing proper ventilation and oxygenation will be vital for a successful resuscitation.
After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin calling out to the victim to assess whether or not the infant is responsive.
Are you OK? Can you hear me?
If you don't get an initial response, place your hand on his or her forehead and tap on the bottom of the baby's feet. If you still do not get a response, proceed with the following steps.
Pro Tip #1: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face.
Performing proper chest compressions is essential for providing high-quality CPR, which greatly improves the patient's chances for a successful outcome.
Chest compressions put pressure on the heart to send oxygenated blood through the arteries to the brain and other vital organs.
Chest compressions also increase the likelihood of a successful AED shock for the patient, particularly if several minutes have elapsed since the patient collapsed or suffered an incident leading to respiratory distress.
Chest compression effectiveness is reduced if:
Warning: Compression rates that exceed 120 per minute tend to have a negative impact on compression depth, perhaps due to responders rushing through them. Regardless, if the compression rate exceeds 120 per minute, you are less likely to compress the full 1/3 of the chest for infants and children, thereby reducing the effectiveness of CPR.
If you are unsure if you're compressing at the correct depth, a feedback device might be helpful.