Cardiopulmonary resuscitation (CPR) is a critical emergency procedure performed when a child’s breathing or heart has stopped, often following incidents like drowning, suffocation, or injury. High-quality chest compressions are fundamental to effective CPR, directly influencing the likelihood of survival in pediatric emergencies. The goal of CPR is to maintain blood flow to vital organs, particularly the brain, until professional medical help arrives. Understanding and applying the correct techniques for chest compressions can significantly improve outcomes for children experiencing cardiac arrest.
Defining a Child for CPR
CPR techniques are tailored to the age and size of the individual, recognizing that children have different physiological needs than infants or adults. In the context of CPR guidelines, a “child” generally refers to an individual from one year of age up to the onset of puberty. Puberty is typically defined by the presence of breast development in females or axillary (armpit) hair in males.
These age-based distinctions are crucial because the force and approach to CPR, including chest compressions, vary significantly to prevent harm and ensure effective resuscitation. Adhering to established emergency medical guidelines, such as those from the American Heart Association (AHA), is important for providing appropriate care.
Core Characteristics of Chest Compressions
Delivering high-quality chest compressions to a child involves specific physical attributes to optimize blood circulation. These characteristics include the appropriate depth, rate, allowing for full chest recoil, and correct hand placement.
Depth
For a child, chest compressions should be approximately 2 inches deep, or about one-third the depth of the chest. This depth ensures adequate blood flow without causing excessive injury. It is important not to exceed 2.4 inches (6 centimeters) in compression depth for a child.
Rate
The recommended rate for chest compressions in children is 100 to 120 compressions per minute. This rapid rate helps maintain consistent blood flow to the heart and brain.
Full Chest Recoil
Allowing the chest to fully recoil after each compression is also a crucial aspect of high-quality CPR. Full chest recoil allows the heart to refill with blood between compressions, maximizing the effectiveness of each subsequent compression. Without complete recoil, the heart may not fill sufficiently, reducing the amount of blood pumped with each compression.
Correct Hand Placement
Correct hand placement involves placing the heel of one hand on the lower half of the child’s breastbone, just below the nipple line. For smaller children, one hand may suffice, while for larger children, using two hands with fingers interlocked might be necessary to achieve the proper depth and force. Positioning the body with straight arms and shoulders directly over the hands helps to utilize body weight effectively for compressions.
Ensuring Continuous Compressions
Minimizing interruptions during chest compressions is crucial for maintaining consistent blood flow and maximizing the effectiveness of CPR. Every pause, even for a few seconds, can significantly reduce the pressure needed to circulate blood to vital organs like the brain and heart. When compressions are interrupted, blood pressure drops, and it takes several compressions to restore adequate circulation once restarted.
The goal is to provide continuous compressions with minimal hands-off time, ideally limiting pauses to less than 5 seconds. This applies even when rescue breaths are also being given, as compressions remain the priority for maintaining circulation. Studies indicate that survival rates decrease when compressions are frequently interrupted.