Cardiopulmonary resuscitation (CPR) is performed when an infant is unresponsive and not breathing normally. In infants, cardiac arrest often results from respiratory failure, requiring immediate action to supply oxygen and circulate blood. Recognizing an emergency involves checking for a response by tapping the infant’s foot and shouting, while observing for normal breathing for no more than ten seconds. The steps and physical measurements for infant CPR are distinct from those used for older children or adults, reflecting the small size of the baby. This protocol involves a combination of chest compressions and rescue breaths to maintain oxygen flow to the brain and other organs.
Establishing the Target Compression Rate and Depth
The required compression rate is standardized at a minimum of 100 compressions per minute. Major resuscitation organizations recommend aiming for a target range of 100 to 120 compressions every minute to ensure adequate blood circulation. The focus is on delivering compressions that are both hard and fast, avoiding lengthy pauses between sets.
Compression depth is equally important for effective circulation. Compressions should be delivered to a depth of approximately 1.5 inches, which corresponds to roughly one-third of the infant’s total chest depth. This depth is necessary to adequately squeeze the heart between the breastbone and the spine, pumping oxygenated blood to the body.
Allowing the chest to fully recoil between each compression is essential for high-quality CPR. Full recoil ensures the chest wall springs back completely, allowing the heart to refill with blood before the next compression. The effectiveness of the compression is significantly reduced if the rescuer leans on the chest, preventing this refill phase.
Proper Infant Chest Compression Technique
Chest compressions on an infant require specific hand or finger placement to prevent injury and maximize effectiveness. The infant should be placed on a firm, flat surface. The correct location for applying pressure is on the center of the breastbone, just below an imaginary line drawn between the nipples.
For a single rescuer performing CPR, the two-finger technique is the standard method used to deliver compressions. The rescuer uses the tips of two fingers, typically the index and middle fingers, placed perpendicular to the chest. This method allows for controlled pressure while minimizing the risk of injury to the infant.
When two trained rescuers are present, the preferred method is the two-thumb encircling hands technique. Rescuers wrap their hands around the infant’s chest, placing both thumbs side-by-side on the sternum. This technique is often more efficient because it achieves a more consistent and deeper compression depth with less effort from the rescuer.
Integrating Rescue Breaths and Rescuer Ratios
Compressions are integrated with rescue breaths according to a specific ratio based on the number of people providing care. For a lone rescuer, the standard is 30 chest compressions followed by 2 rescue breaths, known as the 30:2 ratio. This sequence is repeated, prioritizing the delivery of compressions while still ensuring oxygenation.
When two rescuers are present, the ratio shifts to 15 compressions followed by 2 breaths. The presence of a second rescuer allows for more frequent ventilation, as one person can focus solely on compressions while the other manages the airway and breaths. This synchronized approach helps minimize interruptions to chest compressions, which is important for maintaining blood flow.
Delivering rescue breaths involves gently tilting the infant’s head to a neutral position to open the airway. The rescuer then covers both the infant’s mouth and nose with their own mouth to create a seal. Breaths should be small, gentle puffs of air, delivered over about one second each, just enough to cause the chest to visibly rise.
The rescuer should continue the cycles of compressions and breaths until emergency medical services (EMS) arrive or the infant shows obvious signs of life, such as crying or moving. If the rescuer is alone and has not already called for help, they should perform CPR for about two minutes before pausing to contact emergency services. Minimizing interruptions to the compression cycle is paramount until professional help is on the scene.