Heartsaver/ Pediatric CPR Review Guide
*Updated to Include the New 2000 Guidelines
Workers risk occupational exposure to diseases such as HIV and Hepatitis B viruses through contact with blood and body fluids. OSHA'S "Universal Precautions" policy states that if workers have exposure to blood or body fluids, they should use personal protection such as latex gloves for hands, protective eye wear and use barriers if they have to perform rescue breathing.
"Good Samaritan" legislation helps minimize the fear of litigation so rescuers will feel comfortable helping a victim.
Risk Factors for Cardiovascular Disease - Several factors increase a person's chances of having a heart attack or stroke. The more risk factors a person has the greater the likelihood that he will have a heart attack or stroke.
Risk factors that cannot be changed - heredity, male gender and increasing age.
Risk factors that can be changed or managed - cigarette smoking, blood cholesterol, diabetes, physical inactivity, obesity, stress and high blood pressure. Making positive changes like eating foods low in fat, salt and cholesterol such as fish, fresh fruits and vegetables, exercising more, quitting smoking and getting treatment for high blood pressure and diabetes will help reduce the risk of cardiovascular disease.
Chain of Survival- steps to save a victim in cardiac arrest which include: Early Access (call 911), Early CPR, Early Defibrillation (shock to the heart) and Early Advanced Care
Coronary artery disease (CAD) - affects the arteries that supply blood to the heart muscle. Narrowing of the arteries in the heart can lead to a heart attack. CAD may show up as:
Angina pectoris- temporary chest pain or pressure brought on by physical activity. The pain usually lasts between 2-15 minutes and is relieved by rest and nitroglycerin. If rest and nitroglycerin do not relieve chest pain in 15 minutes, 911 should be called and the patient should be evaluated at the hospital for possible heart attack.
Heart attack- usually occurs when a blood clot completely blocks a coronary artery and kills heart tissue. Symptoms of a heart attack include chest pain that can be described as pressure, fullness or a squeezing sensation located in the center of the chest behind the breastbone. The pain may spread to the jaw, shoulder, neck, and upper back or down one or both arms and usually lasts more than 15 minutes. Other symptoms of a heart attack are fainting, cold clammy skin, nausea, shortness of breath and denial about having a heart attack. This denial behavior is usually what causes the victim to delay getting medical treatment in a timely manner. As a person waits to get treatment, heart muscle dies and the risk of complications or death increases. If a person who is experiencing heart attack symptoms tries to deny there is a problem and is having symptoms of a heart attack, the rescuer should go ahead and activate EMS and monitor the patient until they arrive.
Stroke - results from the blockage or rupture of an artery in the brain. Symptoms include: intense headache of sudden onset, facial, arm or leg weakness or numbness, double vision or loss of vision, especially in one eye, difficulty walking, talking, swallowing or loss of consciousness. Treatment is the same as for heart attack. If symptoms persist for more than 15 minutes, activate EMS and stay with the patient until they arrive. High blood pressure is the number one risk factor for stroke.
Infant and Child Safety - the most common causes of fatal injuries in infants, children and adolescents include motor vehicle crashes, bicycle-related head injuries, burns or smoke inhalation, falls, toy injuries and drowning. No environment is totally safe. Prevention is the key to protecting children from accidents and injuries. Never leave children unattended.
Motor Vehicle & Traffic Safety - Motor vehicle accidents are the number 1 preventable cause of death in children. The back seat is the best seat for children 12 years or younger. No infants or children in car seats should be placed in the front seat of a car with a passenger-side air bag. Guidelines for proper restraint of children in cars are: Infants less than 20 lbs.- use rear-facing car seats in the back seat. Infants more than 20lbs-4year old children-use car seats in the back seat. Children over 4yrs-adults-Use lap and shoulder belts. Booster seats may be needed for 4-7 yr. olds. Call Auto safety hotline at 1-800-424-9393 if you have questions about children and airbag safety. Children riding bicycles should always wear helmets to protect from head injuries.
Burns & Smoke Inhalation - Most indoor burns are caused by scalding from hot liquids. Hot water heaters should be between 120F-130F. Each level of the building should have a smoke detector. Never leave a child unattended while cooking, bathing or ironing.
Falls - The most frequent cause of injuries in children under 6. Falls occur out of cribs, on stairs, and from falling out of windows. Check cribs to make sure they meet government standards for safety. Provide lighting, remove toys, tack down loose carpet & use gates to protect children from falling on stairs or out of windows.
Toy injuries - Most injuries from toys occur when children fall over, choke on pieces or get hit with the toy. Be sure the toy is age appropriate. Don't leave toys lying on ground. And again, supervise children as they play with toys.
General rules of CPR are:
The rescuer never does anything that the victim can do for himself such as breathing etc.
The rescuer always checks each step such as airway, breathing and circulation before administering CPR.
If a rescuer needs to perform CPR on an adult and he is alone, he should activate the EMS before starting CPR. If the victim is a child or infant, the rescuer should perform approximately 1 minute of CPR first to deliver some oxygen and then activate the EMS system, because respiratory failure usually causes circulatory failure in children. According to AHA guidelines, infants are newborn-1yr., children are 1-8yrs and adults are persons over the age of 8.
Sequence of CPR - This sequence is the same for adults, children and infants except where stated. When a person collapses, the following steps should be done in this order:
Check the scene to be sure it is safe for the rescuer to enter- if scene is not safe, do not enter. Call 911.
Put on barriers to protect against blood /body fluids exposure
Check for responsiveness- this is the way to prevent a rescuer from performing CPR on someone who has only fainted.
Call for help-send someone to activate EMS.
Perform ABC Check:
ABC CHECK
A=Airway Open airway with the head tilt/chin lift maneuever if the rescuer does not suspect head, neck or back injury. Put one hand on the forehead and place two fingers under the bony part of the chin and lift up. This lifts the tongue off the airway and allows air to pass unobstructed.
If head, neck or back injury is suspected, do the simultaneous jaw thrust with cervical spine immobilization. Place one hand on the forehead to stabilize the head. Without lifting the head back, lift the chin up. This movement lifts the tongue off the airway without moving the head, neck or back, which could cause damage. The most common cause of airway obstruction in unconscious victims of all ages is improper opening of the airway, which leaves the tongue sitting on the airway.
B=Breathing- involves two steps.
1. To check breathing, the rescuer needs to look, listen and feel for breathing. He should turn his head and look at the victim's chest to see if the chest is rising and falling, listen to see if he can hear breathing and feel for breath on his cheek. All three steps should be done simultaneously.
2. If no breathing is detected, the rescuer should pinch the victim's nose and deliver 2 slow, full breaths over a period of 2 seconds. The rescuer should look at the chest and deliver only enough breath to expand the chest adequately. If the rescuer breathes too fast or too forcefully, gastric distention occurs which force air into the abdomen and increases the likelihood that the victim will vomit.
A special breathing situation is drowning. If the victim has been in cold water submersion, his metabolism slows. Recovery may be complete even after 10-40 minutes of submersion; so CPR and life support should continue for that amount of time. After a victim has been rescued form the water, if the victim is not breathing, rescue breathing should be done (1 breath every 5 seconds for adults, 1 breath every 3 seconds for infants and children.) These rates are to be delivered in any situation where a victim is not breathing but has a heartbeat.
C=Circulation-involves 2 steps:
1. To check circulation, the rescuer checks for return of color (no blueness), signs of movement, coughing or breathing in response to the 2 breaths given. Do not check for more than 10 seconds. If there are no signs of circulation, the victim needs chest compressions as well as rescue breathing.
2. To perform chest compressions for an adult:
Kneel next to the victim's chest and place the heel of one hand on the lower half of the breastbone right between the nipples. Place the heel of the second hand on top of the first hand and clasp the fingers together. Lean forward so your shoulders are above your straightened arms and hands. You should be able to look directly down on your hands.
Compress 1.5-2 inches for adults. For children, use the heel of 1 hand and compress 1-1.5 inches on the lower 1/2 of the sternum. For infants, use 2 fingers (1 finger below the nipple line) and compress 1/2-1 inch. Another practical way to compress hard enough to do effective compressions is to look at the width of the victim's chest and compress 1/3-1/2 the width of the chest. Assessing depth in this manner works for all ages and body sizes.
The compression rate for adults is 15 compressions/2breaths (4 cycles/minute) and 5-compressions/1 breath for infants and children (20 cycles/minute). The compressions should be delivered at a rate of about 100 compressions /minute (slightly faster than 1 compression per second) for adults, children and infants.
After performing CPR for a minute (and every few minutes after that), the rescuer should recheck the ABCs to see if anything has changed in the patient's condition and provide whatever care the patient still needs.
If the victim is breathing , has a pulse and there is no worry about a head, neck or back injury, roll him on his side to protect the airway in case he vomits. Stay with the patient and continue to recheck ABCs until the ambulance arrives. Restart CPR if the victim's condition warrants.
Once a rescuer starts CPR, he should not stop unless the patient revives, someone of equal or greater training comes to relieve him, he is too exhausted to continue, or a signed "Do Not Resuscitate" order is presented. If the rescuer loses track of how may cycles have been completed he should stop compressions, go back to the victim's head, perform another ABC check and start a new cycle, continuing to do for the victim what he cannot do for himself.
Care should be taken to place hands and fingers in the correct position to avoid injury to the patient as CPR is performed. However, rib fractures, laceration of the liver or other internal complications can be minimized but not totally eliminated by effective technique. If the rescuer feels like he has fractured a rib, he should stop long enough to ensure proper hand placement on the chest and then continue with CPR. Fractured ribs can be treated at the hospital- Dead brain tissue cannot be treated anywhere! All victims should be evaluated by a medical professional for complications, even if they seem fine.
Entrance of 2nd Rescuer to replace 1st Rescuer- 2nd rescuer appears and says, "I know CPR. Can I help?" then asks if EMS has been called and checks the pulse. If there is no pulse, the 2nd rescuer starts 1 rescuer CPR while the 1st rescuer checks the pulse and watches the chest rise and fall to make sure compressions and breathing are adequate. Rescuers should alternate roles until EMS arrives.
Foreign Body Airway Obstruction-Care should be taken to try to prevent choking emergencies from occurring. Supervising children when they eat, cutting up food properly and checking floors and cribs for small objects that can obstruct tiny airways are some ways that choking emergencies can be prevented. It is common for an adult or older child victim to grasp at his throat when choking. This sign is known as the universal distress signal for choking.
When the rescuer recognizes this signal, he should go to the victim and ask "Are you choking?" If the victim shakes his head yes, the rescuer should ask, "Can you speak?" If the victim cannot speak, breathe, cannot cough, is turning blue or making high pitched weak sounds, the rescuer should intervene.
The rescuer should say, "I can help you" or "I know the Heimlich Maneuver" to the victim because the victim is usually panicked. This statement will help the victim remain calm so the rescuer can assist him.
To perform the Heimlich Maneuver on a responsive child or adult:
1. Stand behind the victim and make a fist with one hand.
2. Place the thumb side of the fist on the victim's abdomen, slightly above the navel and below the breastbone( Xyphoid Process).
3. Grasp the fist with the other hand and provide quick upward thrusts into the victim's abdomen
4. Continue to deliver thrusts until the victim goes unconscious or the obstruction is relieved. If the victim loses consciousness, ease him to the floor protecting the head, neck and back, activate 911 and start CPR. Each time the airway is opened to attempt rescue breaths, look in the mouth and remove any foreign body that is seen. DO NOT PERFORM BLIND FINGER SWEEPS ON A CHILD OR INFANT BECAUSE THEIR AIRWAYS ARE TOO SMALL.
If the choking victim is an infant (newborn-1Yr), the rescuer should check to see if the child can cough or breathe. Infants turn blue quickly. An infant will not speak or give the rescuer the universal distress signal so the rescuer must listen for high pitched weak sounds or no sounds at all. In addition to being silent or making high pitched weak noises, if the infant is turning blue, cannot breathe or cough, the rescuer must intervene.
To perform the Heimlich Manuever on a responsive infant:
1. Pick up the infant supporting the head and neck by placing one finger under each ear on the jaw and position the infant face down on the rescuers arm. The rescuer's hand should support the head and face. Keep the infant's face down to allow gravity to work with the rescue effort.
2. Deliver up to 5 back blows with the heel of the rescuers' free hand in the center of the chest in between the shoulder blades of the victim.
3. Next, turn the infant onto his back while supporting the head onto the rescuer's other arm- face up. Keep the rescuer's arm down to allow gravity to assist in the effort.
4. Give up to 5 chest thrusts using 2-3 fingers positioned over the lower half of the breastbone ( in the same place as chest compressions are performed for CPR)
5. Alternate 5 back blows and 5 chest thrusts until the object is dislodged or the infant becomes unresponsive.
6. If the infant becomes unresponsive, attempt CPR. During CPR, each time the rescuer opens the airway to provide rescue breaths, he should look in the airway and remove any foreign body seen. DO NOT PERFORM BLIND FINGER SWEEPS ON CHILDREN AND INFANTS BECAUSE THEIR AIRWAYS ARE TOO SMALL.
7. Phone 911 after approximately 1 minute of CPR if alone. Have someone else activate 911 when the victim loses consciousness if there is someone available.
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*Updated to Include the New 2000 Guidelines
Workers risk occupational exposure to diseases such as HIV and Hepatitis B viruses through contact with blood and body fluids. OSHA'S "Universal Precautions" policy states that if workers have exposure to blood or body fluids, they should use personal protection such as latex gloves for hands, protective eye wear and use barriers if they have to perform rescue breathing.
"Good Samaritan" legislation helps minimize the fear of litigation so rescuers will feel comfortable helping a victim.
Risk Factors for Cardiovascular Disease - Several factors increase a person's chances of having a heart attack or stroke. The more risk factors a person has the greater the likelihood that he will have a heart attack or stroke.
Risk factors that cannot be changed - heredity, male gender and increasing age.
Risk factors that can be changed or managed - cigarette smoking, blood cholesterol, diabetes, physical inactivity, obesity, stress and high blood pressure. Making positive changes like eating foods low in fat, salt and cholesterol such as fish, fresh fruits and vegetables, exercising more, quitting smoking and getting treatment for high blood pressure and diabetes will help reduce the risk of cardiovascular disease.
Chain of Survival- steps to save a victim in cardiac arrest which include: Early Access (call 911), Early CPR, Early Defibrillation (shock to the heart) and Early Advanced Care
Coronary artery disease (CAD) - affects the arteries that supply blood to the heart muscle. Narrowing of the arteries in the heart can lead to a heart attack. CAD may show up as:
Angina pectoris- temporary chest pain or pressure brought on by physical activity. The pain usually lasts between 2-15 minutes and is relieved by rest and nitroglycerin. If rest and nitroglycerin do not relieve chest pain in 15 minutes, 911 should be called and the patient should be evaluated at the hospital for possible heart attack.
Heart attack- usually occurs when a blood clot completely blocks a coronary artery and kills heart tissue. Symptoms of a heart attack include chest pain that can be described as pressure, fullness or a squeezing sensation located in the center of the chest behind the breastbone. The pain may spread to the jaw, shoulder, neck, and upper back or down one or both arms and usually lasts more than 15 minutes. Other symptoms of a heart attack are fainting, cold clammy skin, nausea, shortness of breath and denial about having a heart attack. This denial behavior is usually what causes the victim to delay getting medical treatment in a timely manner. As a person waits to get treatment, heart muscle dies and the risk of complications or death increases. If a person who is experiencing heart attack symptoms tries to deny there is a problem and is having symptoms of a heart attack, the rescuer should go ahead and activate EMS and monitor the patient until they arrive.
Stroke - results from the blockage or rupture of an artery in the brain. Symptoms include: intense headache of sudden onset, facial, arm or leg weakness or numbness, double vision or loss of vision, especially in one eye, difficulty walking, talking, swallowing or loss of consciousness. Treatment is the same as for heart attack. If symptoms persist for more than 15 minutes, activate EMS and stay with the patient until they arrive. High blood pressure is the number one risk factor for stroke.
Infant and Child Safety - the most common causes of fatal injuries in infants, children and adolescents include motor vehicle crashes, bicycle-related head injuries, burns or smoke inhalation, falls, toy injuries and drowning. No environment is totally safe. Prevention is the key to protecting children from accidents and injuries. Never leave children unattended.
Motor Vehicle & Traffic Safety - Motor vehicle accidents are the number 1 preventable cause of death in children. The back seat is the best seat for children 12 years or younger. No infants or children in car seats should be placed in the front seat of a car with a passenger-side air bag. Guidelines for proper restraint of children in cars are: Infants less than 20 lbs.- use rear-facing car seats in the back seat. Infants more than 20lbs-4year old children-use car seats in the back seat. Children over 4yrs-adults-Use lap and shoulder belts. Booster seats may be needed for 4-7 yr. olds. Call Auto safety hotline at 1-800-424-9393 if you have questions about children and airbag safety. Children riding bicycles should always wear helmets to protect from head injuries.
Burns & Smoke Inhalation - Most indoor burns are caused by scalding from hot liquids. Hot water heaters should be between 120F-130F. Each level of the building should have a smoke detector. Never leave a child unattended while cooking, bathing or ironing.
Falls - The most frequent cause of injuries in children under 6. Falls occur out of cribs, on stairs, and from falling out of windows. Check cribs to make sure they meet government standards for safety. Provide lighting, remove toys, tack down loose carpet & use gates to protect children from falling on stairs or out of windows.
Toy injuries - Most injuries from toys occur when children fall over, choke on pieces or get hit with the toy. Be sure the toy is age appropriate. Don't leave toys lying on ground. And again, supervise children as they play with toys.
General rules of CPR are:
The rescuer never does anything that the victim can do for himself such as breathing etc.
The rescuer always checks each step such as airway, breathing and circulation before administering CPR.
If a rescuer needs to perform CPR on an adult and he is alone, he should activate the EMS before starting CPR. If the victim is a child or infant, the rescuer should perform approximately 1 minute of CPR first to deliver some oxygen and then activate the EMS system, because respiratory failure usually causes circulatory failure in children. According to AHA guidelines, infants are newborn-1yr., children are 1-8yrs and adults are persons over the age of 8.
Sequence of CPR - This sequence is the same for adults, children and infants except where stated. When a person collapses, the following steps should be done in this order:
Check the scene to be sure it is safe for the rescuer to enter- if scene is not safe, do not enter. Call 911.
Put on barriers to protect against blood /body fluids exposure
Check for responsiveness- this is the way to prevent a rescuer from performing CPR on someone who has only fainted.
Call for help-send someone to activate EMS.
Perform ABC Check:
ABC CHECK
A=Airway Open airway with the head tilt/chin lift maneuever if the rescuer does not suspect head, neck or back injury. Put one hand on the forehead and place two fingers under the bony part of the chin and lift up. This lifts the tongue off the airway and allows air to pass unobstructed.
If head, neck or back injury is suspected, do the simultaneous jaw thrust with cervical spine immobilization. Place one hand on the forehead to stabilize the head. Without lifting the head back, lift the chin up. This movement lifts the tongue off the airway without moving the head, neck or back, which could cause damage. The most common cause of airway obstruction in unconscious victims of all ages is improper opening of the airway, which leaves the tongue sitting on the airway.
B=Breathing- involves two steps.
1. To check breathing, the rescuer needs to look, listen and feel for breathing. He should turn his head and look at the victim's chest to see if the chest is rising and falling, listen to see if he can hear breathing and feel for breath on his cheek. All three steps should be done simultaneously.
2. If no breathing is detected, the rescuer should pinch the victim's nose and deliver 2 slow, full breaths over a period of 2 seconds. The rescuer should look at the chest and deliver only enough breath to expand the chest adequately. If the rescuer breathes too fast or too forcefully, gastric distention occurs which force air into the abdomen and increases the likelihood that the victim will vomit.
A special breathing situation is drowning. If the victim has been in cold water submersion, his metabolism slows. Recovery may be complete even after 10-40 minutes of submersion; so CPR and life support should continue for that amount of time. After a victim has been rescued form the water, if the victim is not breathing, rescue breathing should be done (1 breath every 5 seconds for adults, 1 breath every 3 seconds for infants and children.) These rates are to be delivered in any situation where a victim is not breathing but has a heartbeat.
C=Circulation-involves 2 steps:
1. To check circulation, the rescuer checks for return of color (no blueness), signs of movement, coughing or breathing in response to the 2 breaths given. Do not check for more than 10 seconds. If there are no signs of circulation, the victim needs chest compressions as well as rescue breathing.
2. To perform chest compressions for an adult:
Kneel next to the victim's chest and place the heel of one hand on the lower half of the breastbone right between the nipples. Place the heel of the second hand on top of the first hand and clasp the fingers together. Lean forward so your shoulders are above your straightened arms and hands. You should be able to look directly down on your hands.
Compress 1.5-2 inches for adults. For children, use the heel of 1 hand and compress 1-1.5 inches on the lower 1/2 of the sternum. For infants, use 2 fingers (1 finger below the nipple line) and compress 1/2-1 inch. Another practical way to compress hard enough to do effective compressions is to look at the width of the victim's chest and compress 1/3-1/2 the width of the chest. Assessing depth in this manner works for all ages and body sizes.
The compression rate for adults is 15 compressions/2breaths (4 cycles/minute) and 5-compressions/1 breath for infants and children (20 cycles/minute). The compressions should be delivered at a rate of about 100 compressions /minute (slightly faster than 1 compression per second) for adults, children and infants.
After performing CPR for a minute (and every few minutes after that), the rescuer should recheck the ABCs to see if anything has changed in the patient's condition and provide whatever care the patient still needs.
If the victim is breathing , has a pulse and there is no worry about a head, neck or back injury, roll him on his side to protect the airway in case he vomits. Stay with the patient and continue to recheck ABCs until the ambulance arrives. Restart CPR if the victim's condition warrants.
Once a rescuer starts CPR, he should not stop unless the patient revives, someone of equal or greater training comes to relieve him, he is too exhausted to continue, or a signed "Do Not Resuscitate" order is presented. If the rescuer loses track of how may cycles have been completed he should stop compressions, go back to the victim's head, perform another ABC check and start a new cycle, continuing to do for the victim what he cannot do for himself.
Care should be taken to place hands and fingers in the correct position to avoid injury to the patient as CPR is performed. However, rib fractures, laceration of the liver or other internal complications can be minimized but not totally eliminated by effective technique. If the rescuer feels like he has fractured a rib, he should stop long enough to ensure proper hand placement on the chest and then continue with CPR. Fractured ribs can be treated at the hospital- Dead brain tissue cannot be treated anywhere! All victims should be evaluated by a medical professional for complications, even if they seem fine.
Entrance of 2nd Rescuer to replace 1st Rescuer- 2nd rescuer appears and says, "I know CPR. Can I help?" then asks if EMS has been called and checks the pulse. If there is no pulse, the 2nd rescuer starts 1 rescuer CPR while the 1st rescuer checks the pulse and watches the chest rise and fall to make sure compressions and breathing are adequate. Rescuers should alternate roles until EMS arrives.
Foreign Body Airway Obstruction-Care should be taken to try to prevent choking emergencies from occurring. Supervising children when they eat, cutting up food properly and checking floors and cribs for small objects that can obstruct tiny airways are some ways that choking emergencies can be prevented. It is common for an adult or older child victim to grasp at his throat when choking. This sign is known as the universal distress signal for choking.
When the rescuer recognizes this signal, he should go to the victim and ask "Are you choking?" If the victim shakes his head yes, the rescuer should ask, "Can you speak?" If the victim cannot speak, breathe, cannot cough, is turning blue or making high pitched weak sounds, the rescuer should intervene.
The rescuer should say, "I can help you" or "I know the Heimlich Maneuver" to the victim because the victim is usually panicked. This statement will help the victim remain calm so the rescuer can assist him.
To perform the Heimlich Maneuver on a responsive child or adult:
1. Stand behind the victim and make a fist with one hand.
2. Place the thumb side of the fist on the victim's abdomen, slightly above the navel and below the breastbone( Xyphoid Process).
3. Grasp the fist with the other hand and provide quick upward thrusts into the victim's abdomen
4. Continue to deliver thrusts until the victim goes unconscious or the obstruction is relieved. If the victim loses consciousness, ease him to the floor protecting the head, neck and back, activate 911 and start CPR. Each time the airway is opened to attempt rescue breaths, look in the mouth and remove any foreign body that is seen. DO NOT PERFORM BLIND FINGER SWEEPS ON A CHILD OR INFANT BECAUSE THEIR AIRWAYS ARE TOO SMALL.
If the choking victim is an infant (newborn-1Yr), the rescuer should check to see if the child can cough or breathe. Infants turn blue quickly. An infant will not speak or give the rescuer the universal distress signal so the rescuer must listen for high pitched weak sounds or no sounds at all. In addition to being silent or making high pitched weak noises, if the infant is turning blue, cannot breathe or cough, the rescuer must intervene.
To perform the Heimlich Manuever on a responsive infant:
1. Pick up the infant supporting the head and neck by placing one finger under each ear on the jaw and position the infant face down on the rescuers arm. The rescuer's hand should support the head and face. Keep the infant's face down to allow gravity to work with the rescue effort.
2. Deliver up to 5 back blows with the heel of the rescuers' free hand in the center of the chest in between the shoulder blades of the victim.
3. Next, turn the infant onto his back while supporting the head onto the rescuer's other arm- face up. Keep the rescuer's arm down to allow gravity to assist in the effort.
4. Give up to 5 chest thrusts using 2-3 fingers positioned over the lower half of the breastbone ( in the same place as chest compressions are performed for CPR)
5. Alternate 5 back blows and 5 chest thrusts until the object is dislodged or the infant becomes unresponsive.
6. If the infant becomes unresponsive, attempt CPR. During CPR, each time the rescuer opens the airway to provide rescue breaths, he should look in the airway and remove any foreign body seen. DO NOT PERFORM BLIND FINGER SWEEPS ON CHILDREN AND INFANTS BECAUSE THEIR AIRWAYS ARE TOO SMALL.
7. Phone 911 after approximately 1 minute of CPR if alone. Have someone else activate 911 when the victim loses consciousness if there is someone available.
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posted by Gerry at
10:20 PM
