Infant Resuscitation KEY POINTS: Welcome participants to the course. Introduce yourself and your background. Let participants know about Rescue 7, in business since 1998,do training in first aid, cpr, AED, whmis,confined space etc. Approved and recognized by Provincial and Federal agencies, HRSDC and Heart and Stroke Foundation of Canada. At start of class hand-out participants manuals, roster sheet and health form. Collect forms before class begins Have students introduce themselves and ask if they have taken first aid before Brief overview of the course they will be taking Talk about lunches, breaks and finishing time. Rescue 7 Inc. © 2012

Infant CPR An infant is considered a child under the age of 12 months An infant has a much better chance of survival if CPR is performed immediately If another person is present, tell them to call 911 while you start CPR If you are alone with the infant, do not dial 911 until after you have made an attempt to resuscitate the victim Review the term Sudden Cardiac Arrest (SCA) Cardiac arrest occurs when the heart, for any of a variety of reasons, is not pumping. The patient will be unconscious and not breathing. Cardiac arrest in children is uncommon, unless caused by respiratory failure, and existing heart condition or severe trauma. Respiratory emergencies or failure is the most common cause of the arrest in children and infants.   Review the causes of cardiac arrest in infants Choking Accidental Injuries Electrical Shock Poisoning Suffocation Drowning Preexisting heart conditions Trauma Review signs of cardiac arrest Unresponsiveness Not breathing No signs of circulation Review the purpose of CPR Restore circulation to keep blood circulating and carrying oxygen to the heart, lungs and brain Important Points: Infant CPR is very similar to adult CPR The differences are important to note as the depth of compressions is described in relation to the size of the infant as opposed to cm or inches (1/3 the depth of the chest) Because an infant has a much smaller chest, it is not necessary to perform compressions using two hands. The fingers of one hand often provide enough strength to compress the chest to the proper depth (landmarking is done just below the nipple line of the infant) Rescue 7 Inc. © 2012

Infant CPR Ensure chest rises with each breath Location of fingers Ratio of compressions is 30 for every 2 puffs (breaths) Depth is at least 1/3 AP diameter of the chest. This is about 1 ½ inches Allow chest to recoil completely or return to its normal position Compression rate: 100/minute Recall - CPR Push hard/ Push fast Rate: at minimum 100 compressions per minute Ratio: 30 breath to 2 breaths The differences are important to note as the depth of compressions is described in relation to the size of the infant as opposed to cm or inches (1/3 the depth of the chest)   State the reasons to Stop CPR You are too exhausted to continue Scene becomes unsafe A medical doctor instructs you to stop or EMS takes control Rescue 7 Inc. © 2012

One-Rescuer Infant CPR Scene Survey Check Responsiveness Foot tap Unresponsive = send someone to activate 9.1.1 or do 2 minutes of CPR, then activate 9.1.1 Check Airway Sniffing position Check Breathing Look, Listen and Feel (5 seconds) Not Breathing, Begin 30 Chest Compressions 2 Rescue Breaths, 30 Chest Compressions KEY POINTS: Review the term CPR (Cardiopulmonary resuscitation) Cardiopulmonary resuscitation is the emergency substitution of heart and lung action to circulate oxygen to the brain and other vital organs The two main components of cardiopulmonary resuscitation (CPR) are chest compression to make the heart pump and mouth-to-mouth ventilation to breath for the victim. CPR is required when a victim is unconscious and not breathing.   Review the purpose of CPR Restore circulation to keep blood circulating and carrying oxygen to the heart, lungs, brain, and body. Review the steps of CPR   If an infant is found to be unresponsive, 5 cycles of compressions and breaths should be given before EMS is called. This differs from adult CPR in which EMS is immediately activated (note: if a bystander is available, it is always better to have EMS activated immediately by them. These guidelines apply only if a rescuer is alone) Rescue 7 Inc. © 2012

Infant Choking Choking is when someone can't breathe because food, a toy, or other object is blocking the airway (throat or windpipe) Choking in infants is usually caused by breathing in a small object that the baby has placed in their mouth, such as a button, coin, balloon, toy part, or watch battery Review the difference between partial (mild) and complete (severe) airway obstructions: If the casualty is coughing/crying , it is a partial airway obstruction. If the casualty is unable to cough or talk it is a complete airway obstruction   Prevention Includes: Don't give children under 3 years old balloons or toys with fragile or small parts Keep infants away from buttons, popcorn, coins, grapes, nuts, or similar items Watch infants and toddlers while they are eating. Rescue 7 Inc. © 2012

Infant Choking Signs of choking include: Bluish skin color Difficulty breathing - ribs and chest pull inward Loss of consciousness if blockage is not cleared Inability to cry or make much sound Weak, ineffective coughing Soft or high-pitched sounds while inhaling Rescue 7 Inc. © 2012

Abdominal Thrusts & Back Blows Conscious to Unconscious Determine severity of obstruction Perform five back blows followed by five chest thrusts Continue until airway becomes clear or victim becomes unconscious If the infant becomes unconscious begin the infant CPR sequence  Do NOT perform these steps if the infant is coughing hard or has a strong cry. Strong coughs and cries can push the object out of the airway. If your child is not coughing forcefully or does not have a strong cry, follow these steps: Lay the infant face down, along your forearm. Use your thigh or lap for support. Hold the infant's chest in your hand and jaw with your fingers. Point the infant's head downward, lower than the body. Give up to 5 quick, forceful blows between the infant's shoulder blades. Use the palm of your free hand. If the object does not come out of the airway after 5 blows: Turn the infant face-up. Use your thigh or lap for support. Support the head. Place 2 fingers on the middle of his breastbone just below the nipples. Give up to 5 quick thrusts down, compressing the chest 1/3 to 1/2 the depth of the chest. Continue 5 back blows followed by 5 chest thrusts until the object is dislodged or the infant loses alertness (becomes unconscious). Do Not Do NOT perform choking first aid if the infant is coughing forcefully, has a strong cry, or is breathing enough. However, be ready to act if the symptoms worsen. Do NOT try to grasp and pull out the object if the infant is alert (conscious). Do NOT do back blows and chest thrusts if the infant stops breathing for other reasons, such as asthma, infection, swelling, or a blow to the head. Do give infant CPR in these cases.   Describe the first aid for a child who is choking. Discuss ways to prevent choking Cut food in small, chewable pieces. Keep small objects away from young children. Avoid placing objects such as nails or pins in your mouth for quick access. Avoid eating in a rush. Take time to chew food carefully. Rescue 7 Inc. © 2012

Demonstrations Demonstrate one-rescuer CPR on an infant manikin of 30 compressions and 2 breaths Demonstrate the first aid for choking for a conscious infant victim with a mild airway obstruction, which develops into a severe airway obstruction Demonstrate the first aid for unconscious choking for a conscious infant victim who then becomes unconscious Rescue 7 Inc. © 2012