Infant cardiopulmonary resuscitation (CPR) is a critical intervention that can be life-saving for a baby experiencing a medical emergency. When an infant becomes unresponsive and is not breathing normally, immediate action is necessary to circulate oxygenated blood to their vital organs. Understanding the precise techniques for infant CPR, especially when two rescuers are present, significantly increases the chances of a positive outcome. This guide provides clear instructions on performing two-person infant CPR.
Recognizing the Need for Infant CPR
Recognizing the signs that an infant requires CPR involves quickly assessing their responsiveness and breathing. An infant needing CPR will not respond to stimulation, such as tapping their foot or calling their name. They will also exhibit abnormal breathing patterns, which can range from no breathing at all to gasping or irregular, noisy breaths.
Alongside unresponsiveness and abnormal breathing, it is important to check for signs of poor circulation, which might include pale or bluish skin. If an infant is unresponsive and not breathing normally, it indicates they are in cardiac arrest. In these critical moments, activating emergency medical services (EMS) by calling 911 or the local emergency number is a necessary first step.
The Two-Person Infant CPR Technique
The two-person infant CPR technique involves a coordinated effort between two rescuers, allowing for continuous and effective compressions and ventilations. One rescuer focuses on chest compressions, while the second rescuer manages the airway and provides breaths. For two-person infant CPR, the compression-to-ventilation ratio is 15 compressions followed by 2 breaths.
The rescuer performing compressions should use the two-thumb encircling technique, which is often preferred for two-person infant CPR due to its effectiveness in delivering consistent compressions and promoting better blood flow. This involves encircling the infant’s chest with both hands and placing the thumbs side-by-side on the lower half of the breastbone, just below the nipple line, avoiding the very bottom of the breastbone.
Rescuers should coordinate their actions, with one person counting the compressions aloud to help maintain rhythm and signal when to switch roles. Switching roles approximately every two minutes, or after about 10 cycles of 15 compressions and 2 breaths, helps prevent rescuer fatigue and maintains the quality of compressions.
Key Elements of Effective Infant CPR
Beyond the compression-to-ventilation ratio, several factors contribute to the effectiveness of infant CPR. The proper compression depth is approximately one-third the depth of the infant’s chest, which translates to about 1.5 inches (4 cm) for most infants. Pressing too shallowly will not adequately circulate blood, while pressing too deeply could cause harm.
Compressions should be delivered at a rate of 100 to 120 compressions per minute. Maintaining this rate helps ensure sufficient blood flow to the brain and other vital organs. Allow for complete chest recoil after each compression. This allows the heart to refill with blood before the next compression.
Minimizing interruptions to chest compressions is another important aspect, as blood flow stops whenever compressions pause. Ventilations should be delivered with just enough air to make the infant’s chest visibly rise, avoiding excessive force. Each breath should take about one second to deliver, and rescuers should ensure the chest falls before giving the next breath.
When to Stop or Seek Professional Help
CPR should be continued without interruption until specific conditions are met. One such condition is if the infant shows obvious signs of life, such as purposeful movement, coughing, or normal breathing. If an Automated External Defibrillator (AED) becomes available, it should be used immediately, and its prompts should be followed while continuing CPR as directed.
Another reason to stop CPR is when another trained rescuer arrives and can take over the resuscitation efforts. Ultimately, CPR should be continued until emergency medical services (EMS) personnel arrive and assume care of the infant.