Child Cardiac Arrest: How To Help

Why is it important to start CPR right away for a child experiencing cardiac arrest?

Every second counts in cardiac arrest. Recognizing cardiac arrest and activating the EMS system, immediately beginning CPR, and using an AED as soon as possible gives the person the best chance for surviving the incident.

Is there any difference in doing breaths on an infant than on a child?

The difference is only in the head-tilt/chin-lift technique. For children, tilt the head back to a slightly past-neutral position, which is a little less than for an adult. For infants, tilt the head back to a neutral position.

Do I do chest compressions differently on an infant than on a child?

The approach is the same, but chest compressions are modified slightly for children and infants.

• For a child between the ages 1 to 12, use both hands and compress the chest about 2 inches.
• For a smaller child, you may use one hand, instead of two hands, to give compressions.
• For an infant (under 1 year of age), compress the chest about 1 ½ inches using the encircling thumbs technique (also known as the two-thumb/encircling hands technique).

-Alternatively, you can use the two-finger technique to give compressions.

-If you cannot compress the infant’s chest about 1 ½ inches using the encircling hands or two-finger technique, you can use the one hand technique.

Won’t I break the child’s ribs?

You might, but don't worry about this. Remember your priority is to keep the blood circulating. A damaged rib will mend, but without delivering chest compressions, the child’s chances of survival are significantly reduced.

What if I do chest compressions, but the child is still breathing?

Accidently performing chest compressions on an unresponsive child who is breathing will not create life-threatening injuries. The danger of not providing chest compressions to a child in cardiac arrest clearly outweighs any potential risks.

How long should I do compressions for?

You should keep going until:

• The child shows an obvious sign of life.
• The scene becomes unsafe.
• An AED is ready.
• You’re too exhausted to continue.
• Another trained responder takes over.
• EMS arrives and begins care.

If there is someone else who can help, change every 1 to 2 minutes, with minimum interruption to chest compressions.

Will I restart the heart if I give chest compressions?

Chest compressions pump a small amount of blood around the body to keep the organs—most importantly the brain—alive. Chest compressions significantly increase the possibility of the person being successfully resuscitated when EMS arrive and continue care. The chance of restarting the heart by chest compressions alone is very low. To restart, a heart usually needs an electric shock from a defibrillator.

Can I use a defibrillator?

Yes, you can use an automated external defibrillator (AED) even if not trained. When you turn on the AED, it will prompt you about the steps to take. Many public places, such as train stations and shopping centers, now have them available.

What if the breaths do not make the chest rise?

If the first breath does not cause the chest to begin to rise, retilt the head and ensure a proper seal before giving the second breath.

If the second breath does not make the chest rise when beginning CPR, an object may be blocking the person’s airway.

• Immediately begin chest compressions. The chest compressions used in CPR may dislodge the object.
• Before attempting breaths again, open the mouth and looking for an object in the child’s mouth.
• If you see it, remove it with a finger sweep using your index finger.
• Never do a finger sweep if you don’t see an object because you might push the object further into the child’s airway.

Does it matter where I place each of the AED pads?

It is best to place pads as indicated. But if pad placement is reversed, the AED will still work. Follow the manufacturer’s instructions.

In general, place one pad on the upper right side of the chest and the other pad on the lower left side of the chest a few inches below the left armpit. If the pads touch, position one pad in the middle of the chest and the other pad on the back between the shoulder blades.

Is it safe to use an AED in a pool or when the person is lying in a puddle of water? What about a metal surface?

If the child is in water, remove them from it before using the AED. However, it is safe to use an AED in rain or snow. It is safe to deliver a shock to a child in cardiac arrest on a metal surface as long as appropriate safety precautions are taken.

• Avoid allowing the defibrillation electrodes to contact the metal surface.
• Ensure that no one is touching the child when the shock button is pushed. surviving the incident.