In this lesson, you'll learn how to help a choking victim who is an unconscious infant. And just like our last two fictional choking scenarios, this victim went unconscious while you were trying to help them.
Much of this lesson will look exactly like the last two choking lessons that you just finished. But remember that we learn through repetition, you can always expect to learn a couple new things in every lesson, and the importance of the material, as it could literally save someone's life.
How to Provide Care
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on, and that you have your rescue shield handy.
- Call 911 and activate EMS if you haven't already done so. Enlist the help of a bystander if one is available.
Pro Tip #1: While repetitive and maybe not necessary, it bears repeating: The prevalence of technology has reached a point where everyone has a cell phone or mobile device. And those devices tend to have speakers making them hands-free. Also remember that in an emergency your adrenaline will likely be spiked and your brain mildly dazed and confused. If you're having trouble remembering your rescue skills, dispatch can help.
- Draw an imaginary line across the infant's nipples and place two fingers on the lower part of the sternum in 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.
- Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on infants, use only your fingers to supply the force for the chest compressions, and count as you perform them.
Pro Tip #2: It's important that the infant is laying on a hard surface that can support his or her bodyweight and not one that is padded. If the baby sinks into the surface – like a thick carpet or sofa cushion – this will greatly reduce the effectiveness of chest compressions.
- Conduct compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second.
- Perform 30 chest compressions.
Remember, once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression.
- Lift the infant's chin and put the head into a neutral or slightly sniffing position.
- Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your little finger. If you don't, continue with the following steps.
Pro Tip #3: Do not perform blind finger sweeps, as this can push an object back down the throat and make dislodging more difficult. Only perform a finger sweep if you see something. And with infants, it's best to use your pinky finger.
- 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 a rescue breath and watch for the victim's chest to rise. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions.
- Look inside the infant's mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths.
- If the rescue breaths go in this time – causing the chest to rise and fall – reassess the victim for signs of breathing normally and/or responsiveness.
Remember, we're assuming your chest compressions were able to dislodge the obstruction and you got it out of the victim's mouth. At this point, either they're breathing normally and becoming more responsive, or they're not. If not, continue to perform 30 compression to two rescue breaths.
Continue to perform CPR until EMS arrives, an AED is located, or the victim becomes responsive and begins breathing normally again.