Infant CPR & AED

Emergency Care Online  Course

Objectives

Recognize when cardiopulmonary resuscitation (CPR) and use an automated external defibrillator (AED)

Acting in an emergency is important and can make a difference to a victim of injury or illness.

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Before attempting CPR on someone

There are several things you must do. Make sure you and the patient aren’t in any danger. If possible, resolve the risk or move the patient out of harm’s way. If unable to do so for whatever reason, immediately call 911.
 

Check the patient to determine if they are conscious or not. Do not check for a pulse because time is of the essence and finding a pulse can take too long. Call out to the patient asking, “Are you okay?” Repeat if necessary. If the patient doesn't respond, immediately call 911 and then perform CPR—initiating Circulation, Airway and Breathing tasks (the C-A-B’s). Also, if possible, have someone nearby call 911 and begin CPR, immediately.

Understanding Duty to Act
 

Duty to act is the duty requiring a person to take necessary action in order to prevent harm to another person or to the general public. Whether you are required to follow through depends on the situation and the relationship between the parties. In some cases, breach of duty may put a party at liability for damages.

For laypersons, duty to act requires that you provide care if you have a legal duty. If you do not have a legal duty to provide care, you are not required to provide it.

Fear of providing care
 

There are a number of factors to weigh up when considering providing care. COVID-19 is an important concern, but the risk of contracting diseases can be reduced by wearing personal protective devices like masks, gloves, and gowns that limit exposure.
 

If you feel fear of providing care due to possible legal issues, know that rescuers who provide care without a legal duty and act in good faith are protected by Good Samaritan laws.
 

If the situation is actively unsafe, do not attempt care. If you or the victim are at risk, it is best to call EMS and wait for support to arrive

Fear of providing care
 

In some cases, you may be unable to save a victim. Rescuers should still attempt to provide the best care they are able to. A victim’s chances of survival can be improved by even basic efforts at life support. In accidents, victims who are clinically dead may still be helped when given care. Rescue efforts will not worsen their condition.
 

Following a traumatic situation in which you provided care, you may experience overwhelming emotions. If you continue to feel symptoms like depression, be sure to seek help from a professional source.

Personal Protective Equipment

Putting On Gloves

Use disposable gloves when providing first aid care. If you have a latex allergy, use a latex alternative such as nitrile or vinyl. Before providing care, make sure the gloves are not ripped or damaged.
 

Removing Gloves

Remember to use skin to skin and glove to glove. Pinch the outside wrist of the other gloved hand. Pull the glove off turning the glove inside-out as you remove it. Hold it in the gloved hand. Use the bare hand to reach inside the other glove at the wrist to turn it inside out trapping the other glove inside. Dispose of gloves properly.
 

Out-of-Hospital Chain of Survival

This is the idea that every step in the out-of-hospital chain of survival is critical to a successful outcome, just as every link in a real chain is critical to its integrity. Additionally, a weak link in the out-of-hospital chain of survival also includes any delays in moving from one step to the next.

The earlier these steps take place in an emergency, the better the chance of a patient’s survival.

• Recognition and Activation of EMS
• High-Quality CPR
• Defibrillation
• Advanced Care
• Post Cardiac Arrest Care
• Recovery

Activate EMS – Call 911

Send someone to call and tell them to come back. The caller should give dispatch the patient’s location, what happened, how many people are injured, and what is being done.

If you are alone and no one is available:

• PHONE FIRST for adults and get the AED. Return to start CPR and use the AED for all ages.

• CARE FIRST for children and infants by providing about 5 cycles or 2 minutes of CPR before activating the emergency response number.
  CARE FIRST for all age patients of hypoxic (asphyxial) arrest (ei., drowning, injury, drug overdose).

Compressions

If the victim is unconscious with no normal breathing, begin chest compressions.

Give 30 chest compressions at a rate of 100-120 compressions per minute for all ages.

Hand placement for compressions:

• Child – Hand placement is the same as adult. You may choose to use only one hand in the center of the chest between the nipples for a very small child. Compress at least 1/3 the depth of the chest.

• Infant – Place two fingers on the center of the chest between the nipples. Compress at least 1/3 the depth of the chest.

Airway

Open Airway using head tilt chin lift. Look in the mouth to make sure the air- way is clear. If you see any foreign object, sweep it out right away.

Breathing

Give 2 breaths lasting 1 second each. Watch for chest rise and fall.

Note: If not using a rescue mask, make sure you make a seal over the mouth on an adult or child and pinch the nose closed each time you give a breath. On an infant, make sure to cover the mouth and nose with your mouth.

Continue cycles of 30 compressions to 2 breaths until an AED arrives, advanced medical personnel take over, the patient shows signs of life, the scene becomes unsafe, or you are too exhausted to continue.

CPR Summary

• Check the Scene for Safety
• Check the person for responsiveness and normal breathing
• Call 911
• Give 30 Chest Compressions
  • (Child or infant rate of 100-120 per minute, 1/3 depth of chest)
• Open the Airway
• Give 2 Breaths
• Continue cycles of 30 compressions to 2 breaths.

AEDs

AEDs are designed to shock the heart, in order for the heart to restart under a normal rhythm. The AED analyzes the heart’s rhythm, states whether a shock is advised and then powers up, the operator then pushes a button that will deliver the shock.

Each minute that defibrillation is delayed the chance of survival is reduced by 10 percent. After 10 minutes few people are resuscitated. Early defibrillation increases survival rates to greater than 50%. Rescuers should begin chest compressions as soon as possible, and use the AED as soon as it is available and ready.

If you are giving CPR to a child or infant and the available AED does not have child pads or a way to deliver a smaller dose, it is still recommended to use the AED even with adult pads. With adult pads for a small child or infant, you would place one pad on the center of the chest and the other on the center of the back between the shoulder blades.

AED Considerations

• Remove a patient from standing water, such as in a puddle, before AED use. Rain, snow, or a damp surface is not a concern.

• Patient should be removed from a metal surface if possible.

• Slightly adjust pad placement so as not to directly cover the area if the patient has an obvious bump or scar for a pacemaker.

• Remove medication patches found on the patient’s chest with a gloved hand.

• Never remove the pads from the patient or turn the machine off.

How to Use an AED

1. Turn the AED on and bare the chest. Dry the chest if it is wet. If there is excessive hair you may need to shave it off

2. Place the pads. Place one pad on the patient’s upper right chest above the nipple. Place the other pad on the patients lower left ribs below the armpit. **Follow the directions shown on the pads for the AED pad placement.

3. Quickly check the pads. Make sure pads are pressed down firmly.

4. Follow AED prompts.

5. Stand Clear. Do not touch the patient while the AED analyzes

6. If the AED says, “Shock advised, charging…,” shout, “Clear” and make sure no one is touching the patient. Push the shock button when the AED tells you to.

7. If no shock is advised give CPR if the patient is not moving and not breathing.

8. After the Shock, begin CPR. 

9. The AED will reanalyze every 2 minutes and prompt for a shock if needed.

Child and Infant AED Pad Placement

For children 8 years old and younger and infants, an AED with pediatric pads is preferred. If only a standard AED with adult pads is available, it should still be used for children and infants in cardiac arrest. When placing the pads on a child, the pads should not touch.

For a small child or infant, the pads should be placed one in the center of the chest and one in the center of the back between the shoulder blades.

Infant Choking

• Support the infant’s face and place body on your forearm.
• Keep the infant’s head lower than the feet.
• Administer 5 back blows between the shoulder blades with the palm of your hand.
• Support the infant’s head. Turn the baby over onto your other forearm. Give 5 chest thrusts.
• Continue back blows and chest thrusts until object comes out or infant becomes unconscious.

Special Circumstances for Choking:

• If the patient is pregnant or too large to reach around, give chest thrusts instead.

• If you are giving someone abdominal thrusts and the person goes unconscious, lower the patient safely to the ground
   
• Activate EMS, send someone to call 911

Asthma

Signs & Symptoms

• Shortness of breath or wheezing
• Leaning forward to breath
• Unable to make noise or speak
• Blue lips and fingernails
• Moist skin
• Rapid, shallow breathing
   

Treatment: Activate EMS and keep patient calm. Place in position of comfort. Ask about allergies, asthma, COPD or other medical conditions. If the patient has a prescribed inhaler, assist patient to utilize the device. Check and correct ABC.

Seizures

Signs & Symptoms

• Altered level of consciousness
• Uncontrollable shaking
• Stiffness
   

Treatment: Activate EMS if the reason for the seizure is unknown or it lasts for more than 5 minutes. Protect patient from further harm, place nothing in the mouth, and do not try to restrain the patient. After seizure ends, open the airway, check and correct ABC, and consider moving patient into the recovery position if patient is unconscious and breathing.

Congratulations

You have completed the coursework. You can now continue to the exam by selecting the button below.