Cardiopulmonary resuscitation, or CPR, is performed on an infant who is unresponsive, not breathing and has no pulse, a condition known as cardiac arrest. All caretakers and parents should know how to perform CPR. Receiving proper training and certification can alleviate fears of administering CPR to an infant in an emergency.
Goal
The goal of CPR is to keep the lungs oxygenated and pump blood to the vital organs until medical personnel arrive. Brain damage can occur within 4 minutes after a infants's heart stops beating; death can occur 4 to 6 minutes later, Medline Plus reports.
Unlike adults, who experience loss of heartbeat as a first symptom of cardiac arrest, infants will often stop breathing (apnea) first, according to respiratory therapist Philip Hoberty of Ohio State University.
When to Start CPR
CPR should be administered to any infant who isn't breathing and has no heartbeat. Only trained professionals should check for a heartbeat, Medline Plus states. Caregivers can assume any child who is unresponsive, blue and not breathing has no heartbeat and should start CPR.
Giving breaths will not help if the child is choking on an object, because air won't get past the object into the lungs. If you can't get air into an infant's lung, assume the child has something stuck and give back blows to dislodge the object rather than CPR. As soon as you dislodge the object or can get breaths into the lungs, start CPR unless the baby starts breathing on his own. If a child is struggling but still breathing on his own, do not try to do CPR. Call for emergency medical help instead.
Assessing the Child
A limp, unresponsive, blue or dusky infant is likely in respiratory or cardiac arrest. Don't shake the child violently; rather, move his limbs, call his name, and try and wake him. If you get no response, put your ear near the child's nose and mouth to see if you feel air. If there's any doubt whether the child is in cardiac arrest, start CPR. If someone else is available, have them call for emergency medical help; if not, administer 2 minutes of CPR, then call for help.
Positioning
CPR is most effective when the child is on a flat, hard surface, such as a floor or table. If the surface is too soft, compressions may not massage the heart enough to force blood into the circulatory system. The infant's chin should be tilted slightly upward. Sometimes just repositioning the head will help an infant with abnormal airway structures. Don't over-extend the neck, or you may block the airway and make CPR more difficult.
Performing CPR
Position your mouth over the child's nose and mouth, and place two fingers on the breast bone just beneath an imaginary line drawn from one nipple to the other. The index and middle fingers are the easiest to use. Breath twice into the child's mouth and nose, remembering to lift your mouth away after each breath so air can be expelled.
Give 30 chest compressions for every two breaths. Compress the chest one-third to one-half of the depth of the chest each time. Compress quickly; the rhythm should be like counting---1,2,3,4,5 and up to 30---with no pauses. Let the chest rise between each compression so the heart can refill with blood. Continue CPR until help arrives or you're too exhausted too continue.
