To commemorate the launch of our first month, I will be reviewing a topic that I feel is essential for every parent – Infant CPR. I hope that all of you are never faced with the situation of having to perform infant CPR, and having done my fair share of CPR in he hospital, it can be a very scary thing… however, the truth is that babies choke on food and toys, slip and fall, put their little fingers where they don’t belong and the odds are that some of you may be faced with this terrifying situation. The good news is that YOU can save a baby’s life by knowing what to do!

Infant CPR

Infant CPR is a lifesaving procedure for anyone under the age of 12 months. It is performed when an infant’s breathing or heartbeat has stopped, as in cases of drowning, suffocation, choking, head trauma, electrical shock or poisoning.
Infants, just as children, have a much better chance of survival if CPR is performed immediately. This is because permanent brain damage can occur within minutes after the infant’s blood flow or breathing stops. Therefore, it is of the utmost importance to start infant CPR immediately and attempt resuscitation before leaving to call 9-1-1 (If someone else is with you, have them call 911, but do not leave the child to call for help!); It is most important to continue these procedures until the infant’s heartbeat and breathing return. So let’s focus on the basics of infant CPR or as I like to call them… the A.B.C.’s = AIRWAY, BREATHING and CIRCULATION.
Prior to doing you’re A.BC.’s you need to assess the situation.

Assess the baby

Is the baby conscious? In the medical-anesthesia community we have a saying “a crying baby is a happy baby” because it means that the baby’s airway is open and they can breathe. This is an obvious situation, but to assess a baby gently tap them and call out. If they don’t respond, and they are not breathing have someone call 911. Again, do not leave your baby to call 911… timing is very important at this stage! If you determine that the baby is not breathing, gently place them on their back on a firm surface.
Now it’s time to do the ABC’s!

STEPS OF INFANT CPR

• Step 1: A = AIRWAY. Open the baby’s mouth or AIRWAY.
  Tilt the baby’s head back with one hand and lift their chin up. Positioning the head in this manner will open up the infant’s airway if an obstruction is the cause of the lack of breathing. Briefly check for any movement or breathing.  People typically refer to this step as “look, listen and feel”. To check for breathing put your head next to the baby’s mouth. Look toward the chest for any evidence of a chest rise or breath sounds, you may feel their breaths against your cheek. See the illustration below for details. 
• 
• Step 2:  B = BREATHING.  Give the infant two gentle breaths.
  If your baby isn’t breathing, give two little breaths, each lasting just one second. Cover your baby’s nose and mouth with your mouth and exhale into the lungs only until you see the chest rise (See picture below). Many people are afraid to hurt an infant with their strong breaths… to determine how strong of a breath to give, slowly give a breath until you see the infant’s chest rise, which is just the right amount of air necessary. It is very easy to let your adrenaline take cover and deliver massive breaths which will only fill an infant’s stomach with air or damage their lungs.
  If the chest doesn’t rise, the airway may be blocked. At this point consider changing the position of the head or assess the infant for choking.
• 
• Step 3: C= CIRCULATION. Give the infant 30 chest compressions.
  With the infant in the same position, place the pads of two fingers just below an imaginary line connecting an infant’s nipples.

  With the pads of these fingers just below the nipple line, compress the chest 1/2 to 1 inch. Make sure to make this a smooth rhythmic process. Keep your other hand on the infant’s forehead, keeping the head tilted back. It is very important to give these 30 chest compressions at a rate of 100 per minute. This means giving compressions at a rate just below 2 per second.
  Give her 30 chest compressions at the rate of 100 per minute. When you complete 30 compressions, give two more rescue breaths (step 2, above).
  Now just repeat the cycles…

  Repeat the above steps of 30 compressions and two breaths. Continue the cycles for a minimum of 2 minutes. After 2 minutes, if you’re alone and no help has arrived call 911.  Periodically re-check for breathing until help arrives… If the infant starts breathing do not continue chest compressions.

• 

Again, about calling for help…

If you have help, tell one person to call 911 while another person administers 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 infant with you to the nearest phone (unless you suspect a spinal injury – in which case you should not move the infant.).  

Here are some keys in preventing these types of situations…

Never underestimate what an infant can do. Most infants will surprise you with what they are capable of. PLAY IT SAFE! Never leave an infant unattended. Always use safety straps on high chairs and strollers.
Choose age-appropriate toys. Do not give infants toys that contain small pieces. Inspect toys for small or loose parts, sharp edges, points, loose batteries, and other hazards.
Create a safe environment and constantly supervise your child. Be especially careful around electrical outlets, stove tops, and medicine cabinets.  
To reduce the risk of choking, make sure small objects are out of reach from children. Do not leave coins, nuts, buttons, or grapes near children as their first reaction will be to place these objects in their mouth. Do not allow an infant to crawl or walk while eating or drinking.
Never tie pacifiers, jewelry, chains, bracelets, or anything else around an infant’s neck or wrists.

And Finally…

CPR is best performed by those who have been trained in an accredited CPR course; the procedures described above are not a substitute for CPR training. I encourage all parents to become certified in CPR and ask that you visit http://www.americanheart.org/presenter.jhtml?identifier=3011764  for a class near you.

I look forward to receiving all your questions for next month’s “Ask the Doctors”!
Sincerely,
Dr. Sal Maya

LEGAL DISCLAIMER
The contents of this Site, such as text, graphics, images, and other material contained on the Bumble Collection Site ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. In addition, always seek the advice of your physician or other qualified health professional before starting any new treatment, or making any changes to an existing treatment. Never disregard professional medical advice or delay in seeking it because of something you have read on the Bumble Collection website.

If you think you may have a medical emergency, call your doctor or 911 immediately. The Bumble Collection does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the site. In addition, they receive no additional funding/support from pharmaceutical or private medical companies. Reliance on any of the information provided by the Bumble Collection content, their employees, or monthly guests featured on the web site is solely at your own risk.