According to the American Heart Association, 60 percent of Americans are familiar with CPR, yet only 27 percent of those in cardiac arrest actually receive CPR from a bystander. Because a significant percentage of cardiac emergencies occur out of the hospital, it is important for lay members of the community to be knowledgeable about CPR, including children. The American Red Cross will certify children as young as 11 years old, as long as they can pass the skills test and the necessary written exams. The Red Cross also offers a babysitting course to pre-teens and teenagers, incorporating CPR and first aid training.
Cardiac Arrest in Children
Causes of cardiac arrest among children may include severe bleeding, trauma to the chest, poisoning and electric shock, but the most common reason for pediatric cardiac arrest is because of an unresolved breathing emergency like choking or drowning. A child, knowing CPR, could help resuscitate a peer in need, especially if an adult was not close by. Because unconsciousness is likely related to a breathing emergency, it is important to begin resuscitation efforts immediately to prevent full cardiac arrest.
The ABC's of CPR
The initial assessment for CPR is best remembered by the letters A, B, C. "A" stands for airway; the airway is opened by lifting the chin to tilt the head back. This keeps the tongue from blocking the airway. "B" stands for breathing. Signals of breathing should be checked for about 10 seconds. If the victim is not breathing, two breaths should be given. "C" stands for compressions, which are delivered by placing the hands in the center of the victim's chest and pushing hard and fast, 30 times. The compressions may be difficult for a child or small teen to perform, especially on an adult, because the compression depth should be 2 in. The sequence of 30 compressions, followed by two breaths, is performed continuously until an adult takes over or EMS arrives.
Alternative Version
An equally effective resuscitation technique is called "compression-only CPR." In this version, no breaths are offered because many people are leery of giving mouth-to-mouth resuscitation on another person. So, if the victim is not breathing, the rescuer should immediately begin continuous chest compressions. If the person is unconscious, but breathing, this means the heart is still pumping and CPR is not necessary. Compression-only CPR should be performed until help arrives. This version is not effective on infants.
Signs of Cardiac Arrest
As part of any CPR course, participants should learn about the many warning signs related to a heart attack. Chest pain could be mild or severe, and the pain can radiate throughout the upper torso and arms. The person may also be sweating, short of breath, dizzy or week and feel nauseous. Denial is also a common symptom, precipitating the need for a bystander to call for EMS. Heart attack is one of the most common causes of cardiac arrest in adults, so even children should be aware of heart attack signs and symptoms so they can call 9-1-1.
Children Should Know When to Call 9-1-1
A significant percentage of those suffering a heart attack fail to recognize the important warning signs and consequently end up in cardiac arrest. Dr. Paolo Terranova and colleagues report that approximately 1,000 out-of-hospital cardiac arrests occur each day in the United States. Chance of survival for an out-of-hospital cardiac arrest is less than 5 percent, so it is important for any by-stander, including a child, to call for EMS as soon as the heart attack symptoms start. An early call to 9-1-1 may prevent cardiac arrest, or even death.
References
- American Heart Association: Out-of-Hospital Cardiac Arrest - Statistics, 2009 Update
- American Heart Association: Out-of-Hospital Cardiac Arrest - Statistics, 2007 Update
- PubMed Central: "Indian Pacing Electrophysiology Journal" Early Outcomes of Out-of-Hospital Cardiac Arrest after Early Defibrillation: a 24 Months Retrospective Analysis; 2006
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