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First aid to an infant

Cardiopulmonary resuscitation (CPR), or artificial respiration for infants, is the emergency care we offer to a baby when he has stopped breathing. The information provided here is very useful and may someday help you save your baby’s life. Training in CPR is necessary, in particular for parents of premature babies or babies with apnea or chronic pulmonary disease.

When preparing for the baby’s homecoming, make sure that you have all emergency telephone numbers near every telephone device. In addition, before the baby comes home, familiarize yourself with his normal breathing. Sometimes infants breathe more slowly and more shallowly when sleeping. Also, their breathing is often arrhythmic with accelerations and small pauses.

 

1. Check your infant.

  • Check the infant’s color. If the baby has turned blue (you can see that best on the tongue, the fingers, the lips), this means that oxygen is not reaching the tissues.
  • If your infant seems not to be breathing, stimulate his breath by rubbing his stomach and back.  Breathing can also be stimulated if you lightly hit the sole of the foot.
  • Lay the infant on his back on a firm surface, and support his head and neck.

 

2.   Open the airway.

  • Place one hand on his forehead and two fingers of the other hand on his chin. Lightly push the infant’s head downwards with the hand that is placed on his forehead, so that his nose faces the ceiling.

 

3.    Check if he is breathing.

  • Put your ear near the nose and the mouth of the infant.
  • Look to see if the chest is moving, listen for any breathing from the nose and the mouth, and feel any breathing at your ear.
  • Give two breaths to the infant. (If he is NOT breathing)
  • Open your mouth widely and place it over the infant’s nose and mouth.
  • Give him two breaths, always keeping the airway open (1-1 1/2 seconds per breath).
  • Remove your mouth from the infant between each breath, so that the infant can exhale.
  • Blow enough air so that you make his chest go up and down.
  •   Check for signs of blood circulation.

The infant shows signs of blood circulation if:
– he breathes or responds to the “kiss of life”,
– he coughs,
– he moves.

Let more than 10 seconds pass before you check for blood circulation on the inside of the elbow.

If there are no signs of blood circulation, or if you are uncertain, begin compressions to the chest.

 

Begin compressions to the chest.

·   Imagine an imaginary line between the nipples of the chest. Put two fingers on the chest, at a distance equal to the width of one finger, below the imaginary line.  Press the chest downwards, by 1/2 to 1/3 of the chest’s depth. Do compressions at a rate of 100 times per minute.

·         Give 15 compressions on the chest and then 2 breaths. Repeat the cycle.

Check for signs of blood circulation and breathing.

 

  • After about 1 minute, check for signs of blood circulation and breathing. If circulation and breathing have returned, stay with the infant.
  • If circulation has returned, but the baby is not breathing, give him one breath per 3 seconds.
  • If there are no signs of blood circulation, continue the cycle of breaths and compressions to the chest, beginning with the compressions.

 

4. Call for help

  • If you are alone and begin CPR, continue for a moment. Then get to a telephone, taking the baby with you. Stop the CPR only for as long as you need to call for help, and then begin CPR again. Continue until the baby starts to breathe and shows signs of circulation, or until help arrives.

 

Stelios Papaventsis Paediatrician MRCPCH DCH IBCLC 2009

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