CPR in children, pediatric resuscitation

CPR in infants and children

CPR in children, pediatric cardiopulmonary resuscitation


To this day and fortunately it is very rare for a child to have a cardiorespiratory arrest, hereinafter PCR. PCR is understood to mean the interruption, usually unexpected and potentially reversible, of respiration and of the mechanical activity of the heart.

Cardiopulmonary resuscitation (CPR) is a lifesaving technique used to revive a person who has stopped breathing or whose heart has stopped beating. When performed on children, CPR is slightly different than when performed on adults. For example, compressions should be done with two fingers, one being the thumb, in the center of the chest rather than with both hands.

In addition, the rate and depth of compressions are also different from adults: compressions should be 100-120 per minute and 1/3 to 1/2 the depth of an adult. Rescue breaths are also given more frequently than in adults: after every 5 compressions, a rescue breath should be given.

Finally, special attention must be paid to avoid excessive force when performing CPR on children, since their chest wall can be easily injured due to its fragility.


Why is it necessary to use pediatric cardiopulmonary resuscitation?


Basic CPR is an essential life-saving technique and it is important to know how to perform it on a child. It can be used in various emergency situations, such as when a child has stopped breathing or her heart has stopped beating.

Cardiopulmonary resuscitation maneuvers help restore the flow of oxygenated blood to the brain and other vital organs, helping to prevent potentially serious neurological damage. In addition, it can also help to revive a person who has suffered a cardiorespiratory arrest.

Knowing how to properly perform CPR on a child is crucial for any caregiver, as it can mean the difference between life and death in an emergency situation. Additionally, having knowledge of CPR ensures that the necessary steps are taken quickly and correctly when attempting to save a child's life.


Basic cardiopulmonary resuscitation in pediatrics


Basic resuscitation (CPR) is an important life-saving procedure that anyone who works with or cares for children should know and practice. It can save a child's life in case of cardiac arrest, which is when the heart stops beating normally. When performing CPR on a pediatric patient, be sure to perform compressions appropriate to her size and age.

The rate of compressions should be at least 100-120 per minute for a child younger than 1 year, and at least 80-100 per minute for an older child. Also remember to give rescue breaths between each set of 30 chest compressions. These breaths should also be adjusted based on the size of the child. If you are ever in a situation where you need to perform CPR on a pediatric patient, it is important to remain calm and follow these guidelines to ensure that you provide the best possible care.


Pediatric cardiopulmonary resuscitation (CPR in children). How are the maneuvers performed?


CPR is an important life-saving technique that can be used to resuscitate infants and children who have stopped breathing or have no pulse. CPR for infants and children is performed slightly differently than for adults. For infants, the CPR practitioner should use two fingers to perform chest compressions at a rate of 100-120 per minute, each giving one-second breaths.

For children 1 to 8 years of age, compressions should be done with both hands using the heel of one hand, at a rate of at least 100 per minute. Depending on the age of the child, it may be necessary to deliver breaths with a bag-valve mask or mouth-to-mouth. It is essential that anyone performing CPR on an infant or child receives the proper training so that they can perform it correctly and safely.

The clinical signs to identify a CPA situation in a child are unconsciousness, apnea or agonal breathing (gasping) and absence of pulse or vital signs (does not move, does not breathe, does not cough).

There are studies that show that from 43% to 64% of pediatric patients who present a PCR recover spontaneous circulation with the application of CPR (Pediatric Cardiopulmonary Resuscitation) maneuvers.

pediatric CPR

The maneuvers of cardiopulmonary resuscitation (CPR) are a set of measures and actions that make it possible to identify the PCR situation and, also, aim to replace and try to recover breathing and circulation, constituting the essential treatment of PCR. Its main objective is to ensure a sufficient distribution of oxygen to the brain and other vital organs.

In basic CPR, resuscitation maneuvers are performed without any specific equipment and in instrumentalized CPR, the incorporation of defibrillators is contemplated, to improve ventilation, treatment of defibrillator rhythms, and the safety of the resuscitator (protective material and biosecurity).

On the other hand, in advanced CPR, there is the help of specific material, such as: oxygen, airway instrumentation material or drugs, and it must be applied by specially trained and qualified health personnel.

Pediatric CPR step by step

Before delving into the step by step, it is important to determine that infants are considered to be those under one year of age (except newborns) and children to those over one year of age and up to puberty (in girls up to the presence of breast development). and in children axillary hair).

Next we will detail the sequence of maneuvers that correspond to a Basic CPR according to current recommendations.

  1. Guarantee the safety of the child and the rescuer: if necessary, move the victim to a safe place and the rescuer will protect himself with the measures he has (gloves, signage,...)
  2. Check the response to stimulation: first speak to the child aloud and if there is no response, tactile stimulation (pinches). Avoid jerking. If there is a response to the stimuli, maintain the position and assess whether medical attention is required. Otherwise, continue with CPR.
  3. Call for help and activate emergency medical services (EMS): shout "help", call 112 or 061 and get a defibrillator.
  4. Optimize the child's position: place him/her on a hard, flat surface in the supine position with the head, neck, trunk, and extremities well aligned.
  5. Open the airway: One hand on the forehead and the other lifting the chin, extending the head to a neutral position in the infant, and somewhat more, to the "sniffing" position, in the child. Do not put pressure on the soft tissues under the jaw. Inspect the oral cavity and remove clearly accessible foreign bodies.
  6. Check if there is spontaneous breathing: bring your cheek close to the child's mouth, to "see" if there are thoracic excursions, "hear" if there are respiratory sounds and "feel" the movement of air on your cheek. Do not invest more than 10 seconds. If he is unconscious but breathing, he will be placed in a safety position as long as there are no injuries that prevent it. In the case of non-expiration or gasping, 5 rescue breaths should be administered.
  7. Give 5 rescue breaths to demonstrate airway patency: maintaining the airway open, with the "mouth-to-mouth-nose" technique in infants or "mouth-to-mouth" in children, or with a face mask and self-inflating bag (basic instrumentalized CPR). After each ventilation, the rescuer must completely separate his mouth from the child's, taking a deep breath before the next. Insufflations of approximately 1 second, with the intensity to produce an evident excursion of the child's thorax.
  8. Check for spontaneous circulation “signs of life”: if a pulse rate greater than 60 per minute is detected for sure, continue to keep the airway open by administering between 12 and 20 breaths per minute until more qualified personnel or EMS arrive .
  9. Chest compressions: apply them if there are no signs of life. Compress “quickly and hard”, about 100 compressions/minute, depressing one third of the anteroposterior thoracic diameter (about 4 cm in infants and 5 cm in children). After every 30 compressions, administer 2 breaths. Compressions in infants do them with 2 fingers in the lower third of the chin (below the intermammillary line). In children, use one or both hands superimposed, with arms extended to apply pressure with the heel of the hand on the lower third of the sternum.
  10. Check the effectiveness of CPR manoeuvres: Every 2 minutes from the start of CPR, the compression-ventilation sequence will be briefly stopped to reassess the presence of spontaneous breathing and circulation, using the shortest time possible (no more than 10 seconds). .

The use of the AED is recommended during CPR of children older than 1 year. In children older than 8 years (25 kg), an adult AED should be used, but in children 1 to 8 years of age, it is recommended to use a pediatric AED, with a power attenuator.

If an AED is not available when starting CPR, administer one minute of CPR before going to look for it and, if available, always administer 1 minute of CPR before monitoring. To maintain CPR quality, maintain compressions while electrodes are placed on the child.

En Neosalus We offer you the best caridoprotection to provide prompt attention to this type of problem. Ask us for more information by calling 900 52 56 78 and we will solve all your doubts and questions.