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CPR - child (1 to 8 yrs old)

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Rescue breathing and chest compressions - child; Resuscitation - cardiopulmonary - child; Cardiopulmonary resuscitation - child

First Aid:

The following steps are based on instructions from the American Heart Association.

1. Check for responsiveness. Shake or tap the child gently. See if the child moves or makes a noise. Shout, "Are you OK?"
2. If there is no response, shout for help. Send someone to call 911 and retrieve an AED (if available). Do not leave the child alone to call 911 and retrieve an AED until you have performed CPR for about 2 minutes.
3. Carefully place the child on their back. If there is a chance the child has a spinal injury, two people should move the child to prevent the head and neck from twisting.
4. Open the airway. Lift up the chin with one hand. At the same time, tilt the head by pushing down on the forehead with the other hand.
5. Look, listen, and feel for breathing. Place your ear close to the child's mouth and nose. Watch for chest movement. Feel for breath on your cheek.
6. If the child is not breathing:
   • Cover the child's mouth tightly with your mouth.
   • Pinch the nose closed.
   • Keep the chin lifted and head tilted.
   • Give 2 rescue breaths. Each breath should take about a second and make the chest rise.
7. Perform chest compressions:
   • Place the heel of one hand on the breastbone -- just below the nipples. Make sure your heel is not at the very end of the breastbone.
   • Keep your other hand on the child's forehead, keeping the head tilted back.
   • Press down on the child's chest so that it compresses about 1/3 to 1/2 the depth of the chest.
   • Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be FAST and hard with no pausing. Count the 30 compressions quickly: "1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off."
8. Give the child 2 more breaths. The chest should rise.
9. Continue CPR (30 chest compressions, followed by 2 breaths, then repeat) for about 2 minutes.
10. After about 2 minutes of CPR, if the child still does not have normal breathing, coughing, or any movement, leave the child if your are alone and call 911 . If an AED for children is available, use it now.
11. Repeat step 9 until the child recovers or help arrives.

If the child starts breathing again, place them in the recovery position. Periodically re-check for breathing until help arrives.

Do Not:

• If a spinal injury is suspected, DO NOT tilt the head back when attempting to open the airway. Instead, place your fingers on the jaw on each side of the head. Lift the jaw forward. This keeps the head and neck from moving.
• If the child has signs of normal breathing, coughing, or movement, DO NOT begin chest compressions. Doing so may cause the heart to stop beating.
• Unless you are a health professional, DO NOT check for a pulse. Only a health care professional is properly trained to check for a pulse.

Call immediately for emergency medical assistance if:

• If you have help , tell one person to call 911 while another person begins CPR.
• If you are alone , shout loudly for help and begin CPR. After doing CPR for about 2 minutes, if no help has arrived, call 911. You may carry the child with you to the nearest phone (unless you suspect spinal injury).

References:

Emergency Cardiovascular Care Committee, Subcommittees, and Task Forces of the American Heart Association. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation . 2005;112(24 Suppl):IV1-203.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice . 5th Ed. St. Louis, Mo.: London: Mosby; 2002:83.

• Review Date: 8/31/2007
• Reviewed By: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by William D. Whetstone M.D., Associate Clinical Professor, Division of Emergency Medicine, University of California San Francisco, San Francisco, CA. Review provided by VeriMed Healthcare Network (8/8/2005).

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