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Now we're going to cover one rescuer infant CPR for the healthcare professional. Our scene is safe, our gloves are on, our CPR shield is available with a one way valve. In this situation we received a patient who has possibly been electrocuted. We're going to place one hand on the forehead as we tap and try to stimulate the patient. They do not respond to our taps and shouts. They're unresponsive and they're not breathing normally. If we we are in a situation where we still need to activate EMS we're going to call 911 and then we're going to begin our treatment. If you're in a hospital or clinical setting we maybe now time to call a code. Now as we check for that breathing, to see if they're breathing normally we're also going to feel to a brachial pulse for no more than 10 seconds. We check for that brachial pulse by reaching on the inside of the bicep between the tricep and the bicep on the inside of the arm. We do not feel a pulse and there is no normal breathing. We're going to draw an imaginary line across the nipples and drop our two fingers down on the sternum. When we do our compressions it's important to remember that the depth is going to be approximately one third of the depth of the chest and the rate is going to be between 100 and 120 compressions per minute. It'll look like this. One, two, three, four, five, six, seven, eight, ten, eleven, twelve, thirteen, fourteen, fifteen, sixteen, seventeen, eighteen, nineteen, twenty, twenty one, twenty two, twenty three, twenty four, twenty five, twenty six, twenty seven, twenty eight, twenty nine, thirty. We grab our appropriate sized CPR shield with a one way valve. Let's talk about CPR shield, or in this case rescue masks, for a moment. A rescue mask comes in a couple different sizes whereas a rescue shield is usually a flat piece of plastic with a valve of some sort that's one way. Here you've got something that can work with a bag valve mask well. We see these more often in health care settings. Notice that on this side I have an infant size and on this one I have an adult. If at all possible have the appropriate size for the size of the patient. I have an infant lying here, I have an infant pocket mask so I'm going to use that size appropriately. If all you had was the adult-sized mask there are tricks of the trade by turning it upside down that we could use to try to make it work. In this case we're using the infant sized mask and we're going to cover the nose and the mouth, bring the child's head into a neutral or sniffing position. Sniffing position is when we're - do you smell that apple pie baking? It's just a slight upturn of the nose. It's not a full head tilt chin lift, it's just a nice neutral position. We're going to attempt two rescue breaths. First breath went in. Second breath went in. We know that because we saw a chest rise and fall. With minimization of delay between rescue breaths and chest compressions we begin our second set of 30 compressions. We're going to do this 30 compressions to 2 rescue breaths and we're not going to stop until we're ready to defibrillate.
As you have read already, there are some differences between performing CPR on an adult versus a child. And when it comes to infant CPR, there are even more differences, as you should now be well aware of after the last section on Infant Landmarks.
Infant-related cardiac arrests are typically the result of:
Just as with child CPR, due to the nature of these occurrences, providing proper ventilation and oxygenation will be vital for a successful resuscitation.
After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin calling out to the victim to assess whether or not the infant is responsive.
Are you OK? Can you hear me? (With infants, shouting their name, if you know it, may help.)
If you don't get an initial response and you can see that the infant still isn't breathing normally, place your hand on his or her forehead and tap on the bottom of the baby's feet. If you still do not get a response, proceed with the following steps.
Pro Tip #1: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face. If you have an infant mask, use that. If you don't, there are some tricks to fitting an adult mask onto an infant, such as turning the mask upside down.
Performing proper chest compressions is essential for providing high quality CPR, which greatly improves the patient's chances for a successful outcome.
While it's not entirely understood, it's believed that chest compressions increase the level of pressure inside the chest cavity, which squeezes the heart to stimulate a contraction. This helps to send oxygenated blood through the arteries to the brain and other vital organs.
Chest compressions also increase the likelihood of a successful AED shock for the patient, particularly if several minutes have elapsed since the patient collapsed or suffered an incident leading to respiratory distress.
Chest compression effectiveness is reduced if:
Warning: Compression rates that exceed 120 per minute tend to have a negative impact on compression depth, perhaps due to responders rushing through them. Regardless, if compression rate exceeds 120 per minute, you are less likely to compress the full two-inch minimum (for adults), thereby reducing the effectiveness of CPR.
When it comes to compression depth, research suggests that depths greater than 2.4 inches can lead to non-life-threatening injuries, such as broken or fractured ribs.
If you are a novice or unsure if you're compressing at the correct depth, a feedback device might be helpful.