In this lesson, you'll learn how to perform CPR on an infant. Much of the process will look the same as adult and child CPR, but again there are some subtle yet crucial differences to take note of – namely, the techniques for performing chest compressions and delivering rescue breaths.
Like in the last lesson, we'll assume that in this scenario, an infant has suddenly gone into cardiac arrest and you don't know why.
Pro Tip #1: Babies are very oxygen driven. If you don't know how long an infant has been in cardiac arrest, you should assume that their need for oxygen is extreme and vital for recovery. Which is why beginning CPR trumps everything else, except for making sure the scene is safe.
Infant-related cardiac arrests are typically the result of:
- Drowning
- Choking/airway obstruction
- Electrocution
Regardless of what led to the infant's condition, just as before, all you know for sure is that the victim is unresponsive and not breathing normally, if at all. And that CPR is required.
Pro Tip #2: The compressions you perform on an infant are a bit different than those you perform on adults and children. The depth is still 1/3 the depth of the chest, or in this case, around 1.5 inches. And the rate is still 100 – 120 per minute. However, the technique for performing compressions is different, as outlined below.
Infant CPR Compression Technique
- Remove the infant's clothing to reveal the imaginary nipple line.
- Place two fingers on the center of the infant's chest. Your fingers should be perpendicular to the chest, meaning your knuckles are directly above your fingers during compressions.
- Perform compressions using just your hand and arm strength, not your body weight.
How to Provide Care
Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue shield, and begin calling out to the baby to assess whether or not he or she is responsive.
Are you OK? Can you hear me?
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. If you still do not get a response, proceed with the following steps.
- Call 911 and activate EMS. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc.
Warning: Remember Pro Tip #1? Time is of the essence. If you or someone witnessed the infant go into cardiac arrest and it just happened, call 911. But if you don't know how long the infant has been like that, unless there is a bystander nearby that can call 911 or if your phone is out and ready for use, begin CPR immediately. And call 911 after delivering two minutes of CPR.
- If you've determined at this point that the infant isn't moving or breathing normally and requires CPR, perform 30 chest compressions using the technique outlined above at a rate between 100 – 120 compressions per minute, or around two compressions per second. And remember to allow the chest to fully recoil in-between compressions.
Pro Tip #3: When performing CPR, it's important that the victim is laying on a hard surface. While moving unconscious adults isn't possible, moving infants is, so find a hard surface. Why? When you perform chest compressions on say, a couch, the victim will sink with each compression, thereby reducing the depth of the compressions and the effectiveness of CPR.
- Put the infant's head into a neutral or slightly sniffing position. Babies don't really have necks, so if the chin is too close to the chest or the head is tilted back too far, this will diminish the openness of their airway.
- Grab the rescue shield and place it over the victim's mouth and nose.
- Seal your mouth over the infant's mouth and nose.
- Deliver two rescue breaths – Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath.
Pro Tip #4: What does slightly sniffing look like? Imagine you just walked into a kitchen where someone was baking and you caught a whiff of something good. You raise your head up just slightly as you flex your nostrils for a better scent. That's slightly sniffing.
- If you haven't already called 911, do so now. Otherwise, don't ever interrupt CPR unless it's urgent, like calling 911.
- Go right back into 30 chest compressions followed again by two rescue breaths.
Continue to perform 30 chest compressions to two rescue breaths until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again.
The Five Fears of CPR Rescue
One common problem we see is when people have persistent fears that they can't shed, it prevents them from even attempting to make a rescue.
In this section, we're going to address those fears and hopefully eliminate them, so you'll have the confidence to push through and make a difference when faced with an emergency.
The five fears are:
- Uncertainty of skills. You're worried that you don't know what to do, and that you'll do more harm than good.
- Might hurt or kill the victim. You're worried that a mistake on your part will spell trouble for the victim.
- Lawsuits. You're worried about getting sued, whether someone only thinks you did something wrong or you actually did do something wrong.
- Threat of contracting a disease. You're worried about blood and bodily fluids that contain pathogens that you would then contract.
- The scene is unsafe. You're worried that the scene may be unsafe and that you'll become a victim, too.
At first glance, these fears may sound reasonable. However, let's tackle them one by one using some common sense that should help you eliminate your fears, so that you can become the best rescuer that you can be.
Uncertain of Skills
This should only be a real concern if there's no way for you to refresh your training. However, since we designed our course content to be viewed whenever it's convenient for you, rather than when an instructor is ready to teach, there's really no excuse.
Whenever you feel that you're deficient in a particular area of training, go back to the training library for a refresher. It's self-paced and available 24/7.
Effort and knowledge are the cures for uncertainty. If you put in the time and master your skills, this uncertainty will vanish, and you'll be amazed that you were ever apprehensive to begin with.
Might Hurt or Kill the Patient
When a person is unconscious, isn't breathing normally, and has no pulse, they're already dead. And while it may sound silly to say this, it's true: Their condition cannot get worse.
That person will remain dead unless someone with life-saving skills gets involved. This alone should alleviate a lot of fear and worry about making the situation worse.
During CPR compressions, a lot of new students worry about the possibility of breaking ribs or injuring a patient some other way. But this isn't really possible. Read that first paragraph again – the patient is dead and cannot get worse. However, with your help, they may get better.
Lawsuits
The good news is that since 1985's Good Samaritan Act, people who attempt to help others are protected legally, with a couple of exceptions:
- If you intended to hurt the victim
- If you go above and beyond your level of training
The Good Samaritan Act has essentially immunized people from lawsuits when they try to help others in need.
Threat of Contracting a Disease
As long as you have gloves and a rescue shield, this shouldn't be much of a concern. Those two pieces of equipment will keep those nasty pathogens, if there are any, on the patient's side, while you the rescuer remain on your side.
A Word About Hand's Only CPR
Research has shown that, especially with adults and in the first few minutes, hands-only CPR is just as effective as full CPR. So, if you don't feel comfortable or confident in doing full CPR, or if you're lacking protective equipment, hands-only CPR will still benefit the victim.
The Scene is Unsafe
This is actually a legitimate concern and a reason to delay a rescue attempt. You can still call 911 and get EMS on the way. But if the scene is dangerous, don't do anything that will make you the next victim. Remain at a safe distance until the scene becomes safe, and then go in.
These five fears prevent around 90 percent of people from using the skills they learned. It's natural to have them, but it's essential to shed them. Put in the time and effort when it comes to your training and you'll crush those fears. Someone's life may depend on it.
