Definition
Cardiopulmonary resuscitation (CPR) is the term used to describe the procedure in which oxygen is manually delivered and heartbeat is manually restored in individuals who have stopped breathing and and/or have no heartbeat. CPR for children is delivered to people 1 to 8 years.
Reasons for Procedure
CPR is administered to a child who is not breathing. Reasons for this may include:
- Sudden cardiac arrest
- Cerebrovascular accident
- Trauma
- Burns
- Choking
- Drowning
- Electrical shocks and lightning strikes
- Severe infection
- Drug overdose
- Excessive bleeding
- Hypothermia
Risk Factors for Complications During the Procedure
Complications during CPR depend on the cause of the cardiopulmonary failure. Greater risk is involved if CPR is not administered correctly.
What to Expect
Prior to Procedure
-
Check for unresponsiveness by tapping the patient and asking Are you OK?. Look for signs of breathing (chest rise, feel and listen for breath)
- If someone is with you, have them call 911 immediately.
- If you are alone, perform CPR for at least 1 to 2 minutes before dialing 911.
- If an AED is available, have it brought to the scene. If you are alone, retrieve the AED when you call for help.
Description of the Procedure
During CPR, a trained individual administers mouth-to-mouth resuscitation by blowing air directly into the patient's mouth. The patient's chest is pressed in a regular rhythm to help restore heartbeat.
Mouth-to-mouth resuscitation and chest compression are to be alternated as indicated below.
Position the child so that he is lying on his back.
Open the airway by placing your hand on the childs forehead and lifting the chin with your other hand.
Gently tilt his head slightly backward, pinch the child's nose, and cover his mouth with yours.
Breathe twice into his mouth; until you see the chest rise. Breaths should be about one second each.
Administer chest compressions.
Place the heel of one hand palm down on the chest. Use 1 or 2 hands as necessary.
Straighten your arms and lock your elbows; begin pressing down in a straight motion. The compressions should be about 1/3 to 1/2 the depth of the chest.
Push hard, push fast, at a rate of 100 compressions/minute
Allow the chest to rise completely in between compressions
Minimize interruption between compressions
After 30 compressions, give two rescue breaths.
Use the AED if available after five cycles of CPR or about 2 minutes.
Turn the AED on.
Attached the pads
Follow the prompts. If advised deliver the shock and immediately after resume CPR. If the shock is not advised resume CPR.
Continue cycle of 30 compressions and 2 breaths until help arrives or it becomes unsafe to continue. Emergency personnel will take over care of the patient when they arrive.
During CPR, make sure to tilt the head back to open the airway and allow the chest to rise completely between compressions.
After Procedure
If you have not called 911, do so even if the child has regained consciousness and is breathing on his own. He will need to be evaluated by a physician as soon as possible.
How Long Will It Take?
The length of time for CPR depends on the underlying causes and availability of advanced medical care.
Will It Hurt?
Because CPR is administered when the patient is unconscious, the procedure does not hurt. However, some patients may complain of soreness in the chest after regaining consciousness.
Possible Complications
In frail children, it is possible that ribs may fracture or break during chest compressions. Other complications including puncture of a lung are also possible.
Average Hospital Stay
This depends upon the reason for cardiopulmonary failure and the effectiveness of CPR.
Postoperative Care
Patients will need to be taken to the hospital for evaluation following CPR.
Outcome
Prognosis is dependent on the initial cause, how soon was the CPR initiated, and whether it was performed appropriately. Many patients are unable to regain normal heartbeat after it has stopped.
Call Your Doctor If Any of the Following Occurs
You should always call 911 if CPR needs to be administered, even if the patient begins breathing normally again and heartbeat is restored.
RESOURCES:
American Red Cross
http://www.redcross.org
American Heart Association
www.americanheart.org
The Nemours Foundation
http://www.kidshealth.org/parent/firstaid_safe/emergencies/cpr.html
CANADIAN RESOURCES:
BC Childrens Hospital
http://www.bcchildrens.ca/default.htm
British Columbia Health Ministry
http://www.bchealthguide.org/kbase/topic/special/emerg/sec1.htm
References:
American Heart Association guidelines. 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support. Pediatrics . 2006;117(5):e989-1004. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=16651298 . Accessed February 27, 2007.
American Red Crosswebsite. Available at: http://www.redcross.org .
Bush CM, Jones JS, Cohle SD, Johnson H. Pediatric injuries from cardiopulmonary resuscitation. Ann Emerg Med . 1996;28(1):40-44. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8669737&dopt=Abstract . Accessed February 27, 2007.
Last reviewed January 2008 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
CONTRIBUTE TO THIS STORY
