Understanding Infant Ventilation
Infant ventilation, or rescue breathing, is an emergency procedure for babies who are not breathing or are only gasping. This intervention provides oxygen to the lungs when a baby’s own respiratory system has failed. Prompt action is essential in situations where an infant experiences respiratory arrest.
An “infant” refers to a child under one year of age. This age distinction is significant because infants have unique physiological characteristics, including smaller airways and faster metabolic rates, which necessitate specific ventilation techniques and rates.
Infant ventilation differs from chest compressions, which are part of cardiopulmonary resuscitation (CPR). This article focuses on providing breaths to an infant who has a pulse but is not breathing adequately. Chest compressions are typically added when there is no pulse or the heart rate is very low, indicating cardiac arrest.
Determining the Proper Rate
The correct ventilation rate is essential when providing rescue breaths to an infant. Current guidelines from the American Heart Association (AHA) recommend a specific rate. For infants who have a pulse but are not breathing normally, the suggested rate is one breath every 2 to 3 seconds, which translates to approximately 20 to 30 breaths per minute. This revised guideline increases the respiratory rate from previous recommendations.
The rationale behind this specific rate is to supply sufficient oxygen to the infant’s body while avoiding hyperventilation. Delivering breaths too slowly would deprive the infant of necessary oxygen, while breathing too rapidly or forcefully can lead to complications such as air entering the stomach instead of the lungs. Consistency in timing is important, as it helps maintain a steady supply of oxygen and prevents excessive pressure buildup in the fragile infant lungs.
Safe Ventilation Techniques
Delivering breaths safely and effectively requires careful attention to technique. Correct positioning of the infant’s airway is a primary step; placing the head in a neutral or slightly extended “sniffing position” helps open the airway. This gentle head tilt-chin lift maneuver prevents the tongue from blocking the airway.
Creating a proper seal around the infant’s mouth and nose is crucial for effective ventilation. Rescuers should place their mouth over both the baby’s mouth and nose to form a tight seal. When delivering the breath, it is important to provide only enough air to cause a visible rise of the chest. Avoid using excessive force, as a baby’s lungs are small and can be overinflated.
Common errors to avoid include not getting a proper seal, breathing too rapidly, or over-inflating the lungs. Over-inflation can increase pressure within the chest, potentially reducing blood flow to the heart and leading to gastric inflation. Delivering soft puffs of air rather than deep breaths is necessary for infant ventilation.
Assessing Effectiveness and Further Action
Observing specific signs helps determine if ventilation efforts are effective. A clear indication of successful rescue breathing is a visible rise of the infant’s chest with each breath. This chest movement confirms that air is entering the lungs and not being diverted elsewhere. Additionally, monitoring for the absence of gastric distension, or stomach bloating, suggests that air is primarily going into the lungs rather than the stomach.
Signs of overall improvement in the infant’s condition, such as a return of color to the skin, cessation of gasping, or the onset of spontaneous breathing, indicate that oxygenation is improving. A prompt increase in heart rate is also a significant indicator of effective ventilation. These improvements suggest that the body is receiving the oxygen it needs.
If the infant’s condition does not improve or if their heart rate remains low despite effective ventilation, further action is necessary. Continue rescue breathing efforts, but be prepared to initiate chest compressions if the infant becomes unresponsive, is not breathing normally, and has no pulse or a very low heart rate. It is also paramount to call emergency medical services (EMS) immediately, if not already done, as rescue breathing is a temporary measure to sustain the infant until professional medical help arrives.