In pediatric emergencies, prompt and effective chest compressions are important. Recognizing the signs of cardiac arrest in children and acting quickly can significantly improve outcomes. Cardiopulmonary resuscitation (CPR) provides support to maintain blood flow and oxygen delivery to a child’s brain and other vital organs until professional medical help arrives. Understanding pediatric CPR techniques and guidelines is important.
Recommended Compression Rate
The target rate for chest compressions in children is between 100 to 120 compressions per minute. This rate helps ensure enough blood circulates to the brain and heart. Maintaining a steady rhythm at this pace is important for effective blood flow. This compression rate is consistent across infants, children, and adults, as recommended by organizations like the American Heart Association (AHA).
Proper Compression Technique
Performing chest compressions on children involves specific mechanics. The compression depth should be approximately one-third the anterior-posterior diameter of the chest, about 2 inches (5 cm) for children. Hand placement is on the lower half of the breastbone, or sternum. Allow the chest to fully recoil after each compression.
Continuous compressions with minimal pauses are important to maximize blood flow. For a single rescuer, the recommended compression-to-ventilation ratio is 30 compressions followed by 2 rescue breaths. If two rescuers are present, the ratio changes to 15 compressions to 2 breaths, allowing one rescuer to focus on compressions while the other provides ventilations.
Recognizing the Need for Chest Compressions
Identifying when a child requires chest compressions involves looking for specific signs of cardiac arrest. These signs include unresponsiveness, meaning the child does not respond to gentle tapping or shouting. The absence of normal breathing, which can manifest as no breathing at all or only gasping, is another key indicator. A definitive absence of a pulse, or only a weak or slow pulse, after checking for no more than 10 seconds, also signals the need for compressions.
If these signs are present, immediately calling for emergency medical services (such as 911) is a priority. For lay rescuers, if the child is unresponsive and not breathing, CPR should be initiated without delay. Healthcare providers may assess for a pulse for up to 10 seconds, but CPR should begin if a definite pulse is not felt.
Variations by Age Group
In CPR guidelines, a “child” is defined as someone from 1 year of age up to the onset of puberty. Puberty is indicated by breast development in females or armpit hair in males. For infants, defined as those under 1 year of age, there are modifications in technique. Infants may receive compressions using two fingers for a single rescuer, or the two-thumb encircling hands technique for two rescuers, placed just below the nipple line. Children may receive compressions with the heel of one hand or two hands, depending on their size.
The compression depth also varies: approximately 1.5 inches (4 cm) for infants and about 2 inches (5 cm) for children. Once adolescents reach puberty, adult CPR guidelines are applied, including a compression depth of at least 2 inches (5 cm) but no more than 2.4 inches (6 cm).