Child and Infant Resuscitation Guidelines

There has been much discussion about the correct protocol when giving Cardiopulmonary Resuscitation (CPR) in recent months, which had led to some confusion around the topic. It is not helped by the fact that the protocol for delivering CPR to an infant or child differs from that of an Adult. Most importantly the updated guidelines released from the UK Resuscitation Council have highlighted no major changes to protocol.

What's Important?

Bystanders will have varying levels of training; however there are some basic principles that can be applied in all cases:

• Rapid assessment of a collapsed casualty to ascertain whether they are breathing or not.
• Immediate alert to the emergency services with the correct information. Whenever possible this should be done without leaving the casualty.
• During cardiac arrest blood flow to the brain is cut off. This can cause seizure like episodes that may be confused with normal breathing.

Correct Protocol

The child and infant nearly always suffer a respiratory cardiac arrest whereby there airway has become blocked and as a result have run out of oxygen. Typical examples include a child / infant who has choked or drowned. The situation is extremely serious but it is possible to move towards reviving them by following the below protocol:

• Administer five initial breaths by forming a seal over the mouth. The breaths should be gentle and last no longer than 1 second with a pause in between each breath.
• Deliver 30 chest compressions at a speed of between 100-120 per minute. Compression depth should be one third of the chest diameter, roughly 4 cm for the infant or 5 cm on a child.
• Deliver two rescue breaths following the same protocol as the initial five.
• Continue a cycle of 30 chest compressions and two rescue breaths until a trained professional takes over or upon successful recovery of the casualty.

The continuation of CPR will hopefully prevent the condition from worsening and promote a recovery in the interim period between initial collapse and arrival of a trained medical team. Sadly it is highly unlikely that a non breathing casualty will recover through CPR alone, but it is imperative to prevent irreversible damage (notably brain) within the inner body.