Would you know what to do in the unthinkable event that your child stopped breathing? Such emergencies while rare, do sometimes occur, typically as a result of choking, electrical shock, drowning, or an allergic reaction. Being an expectant parent, this thought has crossed my mind and is one reason I became a CPR instructor. Cardiac arrest in infants and young children is usually the result of lack of oxygen caused by respiratory difficulty or arrest. Injuries and poising account for more than 8000 fatalities in children under age 15 every year. Nearly half of all injuries involve vehicle accidents, and about 20% involve burns, firearms, and poisoning. This is also the reason why any parent or caregiver to children should become familiar with the lifesaving CPR skills described here.
 

One-Rescuer CPR: Child (1 to 8 years)

CPR performed on young children is similar to CPR for adults and older children except for four differences:

• If the rescuer has no help, give about 1 minute of CPR before activating EMS system.

• Use the heel of one hand in chest compressions rather than both hands.

• Depress the sternum one third to one half the depth of the chest (about 1 to 1 1/2 inches).

• Provide 100 compressions per minute, giving 1 rescue breath for every 5 chest compressions.

AIRWAY
Assessment: Determine unresponsiveness. Tap or gently shake shoulder and shout "Are you OK?" If no response call out "Help!" Position the victim on his or her back, taking care to support the head and neck in case of injury. Open the airway, using head tilt-chin lift.

BREATHING
Assessment: Determine breathlessness. With your ear over the child's mouth, look at the chest and look, listen, and feel for breath while keeping the airway open. If the victim is not breathing, give 2 rescue breaths, mouth to mouth (1 to 1 1/2 seconds per breath). The chest should rise with each breath, then fall.

CIRCULATION
Assessment: Determine pulselessness. Using two or three fingers, feel for the carotid pulse (side of the neck) with one hand while maintaining head tilt with the other. (Do this for approximately 5 seconds). If no pulse, begin chest compressions. Find proper hand position as in adults. Compress the sternum approximately one third to one half the depth of the chest (this will be approximately 1 to 1 1/2 inches, although these measurements are not precise). Use only the heel of one hand. Compress the chest 100 times per minute, giving 1 rescue breath for every 5 compressions. Do 20 cycles of compressions and rescue breaths. Call the EMS system (call 911). Check pulse. If no pulse, continue compressions and rescue breaths. Check the pulse every few minutes. If the pulse returns, check for spontaneous breathing. If there is no breathing, give 1 rescue breath every 3 seconds (20 rescue breaths per minute) and monitor the pulse. If the victim is breathing, place in the recovery position (on the victims side), maintain an open airway, and monitor breathing and pulse until EMS arrives. Remember to stay calm.
 

The safest way to use this guide is in conjunction with a CPR class. Employees of Johns Hopkins Bayview Medical Center can participate in a CPR marathons which are offered throughout the year, usually in February, June, and October. Interested people can contact the nursing office at X-0179 and keep a close eye on the Banner.

If you live in the community and would like to participate in a CPR class please call 550-0860. Classes are offered for a small fee. It is important to remember the time spent preventing conditions that cause cardiorespiratory deterioration in infants and children is much more productive than time spent mastering CPR techniques. Special attention must be paid to making environments safe for children but it is also important to know CPR.