BLS - CHILD & INFANT

TOPIC- Verify scene safety, check for responsiveness, and get help.

STEPS

1. verify that the scene is safe for you and the victim . you do not want to become a victim yourself

2. check for responsiveness. tap the child's shoulder or the heel of the infant's foot shout, ''are you OK? "

3. if the victim is not responsive, shout for nearby help. activate the emergency response system via mobile device (if possible)

TOPIC- Assess for breathing and pulse.

Next, assess the infant or child for normal breathing and a pulse. this will help you determine the appropriate actions.

To minimize delay in starting CPR, you may assess breathing at the same time as you check the pulse. This should take no more then 10 seconds.

Breathing

To check for breathing, monitor the victim's chest for rise and fall for no more then 10 seconds.

• if the victim is breathing, monitor the victim until additional help arrives.

• if the victim is not breathing or is only gasping, the victim has respiratory or (if no pulse is felt) cardiac arrest. (gasping is not considered normal breathing and is a sign of cardiac arrest).

Check Pulse

• infant: To perform a pulse check in an infant, palpate a brachial pulse .

• child: To perform a pulse check in a child, palpate a carotid or femoral pulse.

it can be difficult for BLS providers to determine the presence or absence of a pulse in any victim, particularly in an infant or child.so if you do not definitely feel a pulse within 10 seconds, start CPR, beginning with chest compressions.

TOPIC -Infant: Locating the Brachial Artery Pulse.

To perform a pulse check in an infant, palpate for a brachial pulse . follow the steps below to locate the brachial artery and palpate the pulse. if you d not definitely feel a pulse within 10 seconds. begin high quality CPR, starting with the chest compression.

Steps

1. Place 2 or 3 finger on the inside of the upper arm, midway between the infant's elbow and shoulder

2. Then press the finger to attempt to feel the pulse for at least 5 but no more then 10 seconds.

TOPIC- Child: Locating the femoral Artery Pulse.

To perform a pulse check in a child, palpate a carotid or femoral pulse. if u do not definitely feel a pulse within 10 seconds, begin high quality CPR, starting with the chest compressions.

Steps

1. Place 2 fingers in the inner thigh, midway between the nipbone and the pubic bone and just below the crease where the leg meets the torso.

2. Feel for a pulse for at least 5 but no more then 10 seconds. if you do not definitely feel a pulse, begin high quality CPR, starting with the chest compressions.

TOPIC-Determine Next Actions.

IF - if the victim is breathing normally and a pulse present .

THEN- Monitor the victim.

IF-If the victim is not breathing normally but a pulse is present.

THEN- Provide rescue breathing.

• Add compressions if pulse remains 60/min or less with signs of poor perfusion.

• Confirm that the emergency response system has been activated.

• continue rescue breathing and check pulse about every 2 minutes. be ready to perform high quality CPR if you do not feel a pulse or if there is a heart rate less then 60/min with signs of perfusion.

IF-if the victim is not breathing normally or is only gasping and has no pulse.

THEN- If you are alone and the arrest was sudden and witnessed.

• Leave the victim to activate the emergency response system in your setting. For example, call your local emergency number from your phone, mobilize the code team, or notify advanced life support.

• Get the AED and emergency equipment.if someone else is available, send that person to get it.

if you are alone and the arrest was not sudden and witnessed.

• Continue to the next step: Begin high quality CPR for 2 minutes.

TOPIC-Was the collapse sudden?

if the victim is not breathing or only gasping and has no pulse, and the collapse was sudden and witnessed, leave the victim to activate the emergency response system( unless you have already done so by mobile device) and retrieve the AED . if others arrive, send them to activate he system( if not already done) and retrieve the AED while you remain with the child to begin CPR.

TOPIC- Begin HIGH-QUALITY CPR, Starting with chest compressions .

if the victim is not breathing normally or is only gasping and has no pulse, begin high quality CPR, starting with the chest compressions. remove or move the clothing covering the victim 's chest so that you can locate appropriate hand or finger placement of AED pads when the AED arrives.

single rescuers should use the following compressions techniques.

• Infant: 2-finger chest compressions.

• Child: 1- or 2 hands( whatever is needed to provide compressions of adequate depth).

after about 2 minutes of CPR,if you are still alone and were unable to activate the emergency response system (no mobile phone), leave the victim to activate the emergency response system and get the AED as soon as it is available.

TOPIC- Attempt Defibrillation with the AED.

use the AED as soon as it is available and follow the prompts.

TOPIC-Resume HIGH-QUALITY CPR.

After the shock delivery or if no shock is advised, immediately resume high-quality CPR, starting with the chest compressions, when advised by the AED. continue to provide CPR and follow the AED prompts until advanced life support providers take over or the child begin to breathe, move, or otherwise react.

INFANT/CHILD CHEST COMPRESSIONS

TOPIC-Compression Rate and Compression-to - ventilation Ratio.

The universal rate for chest compressions in all cardiac arrest victim is 100 to 120/min. The compression-to-ventilation ratio for single rescuers is the same (30:2) in adults,children, and infants.

if 2 rescuers are present for the resuscitation attempt of an infant or child, use a compression to ventilation ratio of 15:2.

TOPIC-Chest Compression Technique.

For most children, either 1 or 2 hands can be used to compress the chest.for most children, the compression technique will be the same as for an adult: 2 hands (heel of one hand with heel of other hand on top of the first hand). for a very small child,1- handed compressions may be adequate to achieve the desired compression depth. compress the chest at least one third the anteroposterior (AP) diameter of the chest (about 5 cm) with each compression.

For infants, single rescuers should use the 2-finger technique. if multiple rescuers are present , the 2 thumb-encircling hands technique is preferred. these techniques are described below.

TOPIC-Infant (1 Rescuer): 2-Finger Technique

Follow these steps to give chest compressions to an infant by using the 2- finger technique.

STEPS

1. Place the infant on firm, flat surface.

2. Place 2 fingers in the center of the infant's chest, just below the nipple line, on the lower half of the breastbone.Do not press the tip of breastbone

3. Give compressions at a rate of 100 to 120/min.

4. Compress at least one third the AP diameter of the infant's chest (about 4 cm).

5. At the end of each compression, make sure you allow the chest to fully recoil (reexpand); do not lean on the chest. chest compression and chest recoil/ relaxation times should be about equal. minimize interruptions in compressions (eg, to give breath) to less then 10 seconds.

6. After every 30 compressions, open the airway with a head tilt-chin lift and give 2 breaths, each over 1 second . the chest should rise with each breath.

7. After about 5 cycles or 2 ,minutes of cpr, if you are alone and the emergency response system has not been activated, leave the infant (or carry the infant with you) to activate the emergency response system and retrieve the AED.

8. Continue chest compressions and breath in a ratio of 30:2, and use he AED as soon as it is available. continue until advanced providers take over or the infant begins to breath,move or otherwise react.

TOPIC-Infant: 2 Thumb- encircling Hands Technique

The 2 thumb-encircling hands technique is the preferred 2-rescuer chest compression technique because it produces improved blood flow.

Follow these steps to give chest compressions to an infant by using the thumb-encircling hands technique.

STEPS

1. Place the infant on a fir, flat surface.

2. Place both thumb side by side in the center of the infant's chest, on the lower half of the breastbone. the thumb may overlap in very small infant. encircle the infant's chest and support the infant's back with the fingers of both hands.

3. with your hands encircling the chest, use both thumbs to depress the breastbone at a rate of 100 to 120/min.

4. compress at least one third the AP diameter of the infant's chest (about 4 cm).

5. After each compressions, completely release the pressure on the breastbone and allow the chest recoil completely.

6. After every 15 compressions, pause briefly for the second rescuer to open the airway with a head tilt-chin lift and give 2 breaths, each over 1 second.the chest should rise with each breath. minimize interruptions in compressions (eg, to give breaths) to less than 10 seconds.

7. continue compressions and breath in a ratio of 15:2 (for 2 rescuers). the rescuer providing chest compressions should switch roles with another provider about every 5 cycles or 2 minutes to avoid fatigue so that chest compressions remain effective. continue CPR until the AED arrives,advanced providers take over, or the infant begins to breath, move or otherwise respond.