Cardiopulmonary Resuscitation (CPR) is a time-sensitive intervention performed when a person’s breathing or heart has stopped. This technique manually circulates oxygenated blood to the brain and other organs until professional medical help arrives. CPR methods must be tailored to the size and physiology of the person receiving aid, as a child’s body is fundamentally different from an adult’s. Standardized guidelines ensure compressions and ventilations are delivered effectively, optimizing the chance for survival. Rescuers must be aware of the specific age classifications used in training.
Defining the Age Categories in Pediatric CPR
CPR techniques are divided into three major categories based on age and developmental stage. The “Infant” category covers newborns up to one year of age, requiring a delicate approach to compressions and breaths. The “Adult” category typically begins at the onset of puberty, defined as any victim exhibiting secondary sex characteristics or generally anyone over 12 to 14 years old.
The “Child” age range bridges these groups, generally defined as one year of age up to the onset of puberty. While some guidelines use a specific age, such as up to eight years old (especially for Automated External Defibrillator or AED usage), the one-year-to-puberty definition is the clinical standard for manual CPR. This distinction is necessary because a child’s body is too large for infant techniques but too small for adult resuscitation methods.
Key Differences in Manual CPR Technique for Children
Manual CPR on a child requires specific modifications due to the child’s smaller size and different chest wall compliance. The goal is to compress the chest by approximately two inches, or about one-third the front-to-back depth of the chest. This is shallower than the adult requirement. A rescuer can use the heel of one hand or two hands, depending on the child’s size, ensuring that only the breastbone is compressed.
The rate of compressions remains consistent across all age groups, targeting 100 to 120 compressions per minute. A child’s cardiac arrest is commonly triggered by respiratory failure or shock, leading to a lack of oxygen, unlike adult arrests which often stem from primary heart problems. This difference makes rescue breaths particularly important; hands-only CPR is less ideal for children.
When a lone rescuer is present, the compression-to-ventilation ratio for a child is 30 compressions followed by two breaths. If two rescuers are available, the ratio shifts to 15 compressions to two breaths to increase the frequency of ventilations. The child’s airway must be opened to a slightly past-neutral position using the head-tilt/chin-lift maneuver, delivering a breath just strong enough to make the chest visibly rise.
AED Usage Guidelines for the Child Age Group
Using an Automated External Defibrillator (AED) on a child requires specific adjustments based on the victim’s age and size. For children between one and eight years old, it is recommended to use attenuated pads or an AED with a child key or switch. These specialized components reduce the energy dose delivered, making the shock safer for a smaller body. If pediatric pads or a dose-attenuating system are unavailable, adult pads should be used, as delivering a shock is preferable to delaying defibrillation.
Proper placement of the pads is modified to ensure the heart is targeted without the pads touching, which could short-circuit the electrical current. The preferred placement is often an anterior-posterior configuration, with one pad placed on the front of the chest and the other on the child’s back. This positioning ensures the electrical current passes through the heart effectively. The AED device analyzes the heart rhythm and advises whether a shock is necessary, guiding the rescuer through the process.