Cardiopulmonary Resuscitation for Children Age 1 to Early Teens
Definition
Cardiopulmonary resuscitation (CPR) is a series of steps to help a person who is not responding and has stopped breathing. CPR helps deliver oxygen rich blood to the body tissue when the body is not able to do this on its own.
Reasons for Procedure
CPR is given to a child who is not breathing. Reasons for this may include:
- Trauma
- Sudden cardiac arrest
- Cerebrovascular accident (bleeding in the brain)
- Burns
- Choking
- Drowning
- Electrical shocks and lightning strikes
- Severe infection
- Drug overdose
- Excessive bleeding
- Hypothermia
The outcome will depend on the initial cause and how soon effective CPR was initiated. Many victims are unable to regain a normal heartbeat after it has stopped.
Possible Complications
In frail children, it is possible that ribs may fracture or break during chest compressions. Other complications, like a puncture of a lung, are also possible.
People with weakened bones have a higher risk of fractures from CPR. However, there is far greater risk of death if CPR is delayed or not done correctly.
What to Do
Prior to Procedure
When you see a child suddenly collapse or find a child unconscious on the ground, immediately check to see if he is responsive. Tap the child and ask: “Are you OK?†If the child is unresponsive, follow these steps:
- If someone is with you, have that person call 911 and get the automatic external defibrillator (AED). An AED is a device that delivers electric shocks to the person's heart. If you are alone, do CPR for about two minutes before calling 911 and getting the AED.
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If the person is not breathing or only gasping, begin CPR by doing chest compressions:
- Place the palm of your hand on the lower half of the chest directly over the sternum. One or two hands may be used.
- Straighten your arms and lock your elbows. Begin pressing down in a straight motion. The compressions should be at least two inches deep.
- Push hard and fast at a rate of 100 compressions per minute.
- Allow the chest to rise completely between compressions.
- Minimize interruption between compressions.
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If you are trained in CPR, give two rescue breaths after 30 compressions. To give rescue breaths:
- Open the airway by placing one hand on the forehead and lifting the chin with your other hand.
- Gently tilting the head backward, pinch the victim's nose and cover his mouth with yours.
- Breathe twice into his mouth until you see the chest rise. Breaths should be about one second each.
- After giving two rescue breaths, do 30 compressions. Continue the cycle of two breaths and 30 compressions.
- If you are not trained in CPR, continue doing the chest compressions without giving rescue breaths.
- If another person is present, take turns doing the chest compressions to avoid fatigue. If two people are giving CPR, the ratio of chest compressions to breaths is 15 compressions and then two breaths.
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Give CPR until the AED is brought to the scene or until:
- Medical help arrives
- It becomes unsafe to continue
- The victim regains consciousness and is able to breathe
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To use the AED:
- Turn the AED on.
- Attach the pads.
- Follow the prompts. If advised, deliver the shock. If the shock is not advised, the AED will tell you to resume CPR.
How Long Will It Take?
The length of time for CPR depends on the underlying causes and response time of medical help.
Will It Hurt the Child?
The patient is unconscious when CPR is given. The procedure does not hurt. Some victims may complain of soreness in the chest after regaining consciousness.
Post-procedure Care
The emergency team will take over care when they arrive.
Victims will need to be taken to the hospital for evaluation following CPR.
Resources:
American Heart Association
American Red Cross
Canadian Resources:
Health Canada
Heart and Stroke Foundation of Canada
References:
American Heart Association guidelines. 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support. Pediatrics. 2006;117(5):e989-1004. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus...st_uids=16651298. Accessed January 12, 2009.
American Heart Association. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science: Part 1 executive summary. American Heart Association website. Available at: http://circ.ahajournals.org/cgi/content/full/.../18_suppl_3/S640. Published October 2010. Accessed October 21, 2010.
American Heart Association. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science: Part 13 pediatric basic life support. American Heart Association website. Available at: http://circ.ahajournals.org/cgi/reprint/122/18_suppl_3/S862. Published October 2010. Accessed December 21, 2011.
American Heart Association. Heartsaver First Aid with CPR and AED. Dallas, TX: American Heart Association; 2006
American Red Cross website. Available at: http://www.redcross.org.
Bush CM, Jones JS, Cohle SD, Johnson H. Pediatric injuries from cardiopulmonary resuscitation. Ann Emerg Med. 1996;28(1):40-44. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=86...37&dopt=Abstract. Accessed January 12, 2009.
Bardy, G.H. A critic's assessment of our approach to cardiac arrest. New Engl J of Med. 2011;364(4):374-375.
Topjian AA, Berg RA, Nadkarni VM.Pediatric cardiopulmonary resuscitation: advances in science, techniques, and outcomes. Pediatrics. 2008 Nov;122(5):1086-98. Review.
Last reviewed December 2011 by Ganson Purcell Jr., MD, FACOG, FACPE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.