Lesson 4: Basic Life Support for Children and Infants

That's correct! Amy compressed the chest about ______ or one-third the anterior-posterior diameter of the chest.

2 inches (5 cm)

When performing single-provider CPR on a child, the compression/ventilation ratio is ___

30:2

how to check for an infant response?

Olivia for responsiveness, first shout her name and "Are you OK?" Then, tap the bottom of the foot and shout again.

What is the first step of the Pediatric Cardiac Chain of Survival?

Prevention of arrest

You initiate CPR on an 11-year-old female patient who shows signs of puberty, including breast development. Which BLS guideline should you follow?

Adult

A 5-year-old child experiences cardiac arrest and requires CPR. You ensure that high-quality CPR is administered when you compress the chest to which depth?

about 2 inches

CPR/AED protocol infant

someone under the age of 1

You initiate CPR on a 12-month-old male patient. Which BLS guideline should you follow?

Child

Next, Amy must simultaneously check for breathing and a pulse. Choose the recommended location to perform the pulse check.

Neck

You come upon a child who has collapsed. The child is not breathing normally and does not have a pulse. You are alone and have no immediate access to a phone or other form of communication. Which action would you do first?

Perform about 2 minutes of CPR, starting with chest compressions.

where is the to find the pulse for infant?

pulse is at the brachial artery in the arm.

Most common causes of cardiac arrest in pediatric?

respiratory emergencies, congenital heart disorders and trauma. preventable injury (such as trauma, drowning, choking or electrocution).

CPR/AED protocol adolescent

someone from the onset of puberty through adulthood.

Amy should simultaneously check for breathing and a _____pulse for at least ____seconds but no more than 10.

carotid 5

You would use pediatric AED pads for which children?

-2-year-old weighing 27 lbs -5-year-old weighing 43 lbs

If Theo were unresponsive and not breathing normally (or only gasping) but had a pulse____with signs of poor perfusion, she would tell Joe get help and an AED. Then, she would begin CPR. She would continue compressions and ventilations checking the pulse and breathing about every 2 minutes. If during pulse checks Theo's pulse increased to greater than 60 bpm, Amy would stop chest compressions but continue providing 1 ventilation every ____seconds as long as Theo remained in respiratory arrest. If she did not find a pulse, she would continue CPR.

≤ 60 bpm 3 to 5

After recognizing that Olivia is in cardiac arrest, Dr. Dave should initiate CPR within ____ seconds.

Yes, that's correct. After recognizing that Olivia is in cardiac arrest, Dr. Dave should initiate CPR within 10 seconds.

An 8-year-old child experiences cardiac arrest. On which area would you would complete a pulse check?

carotid artery (neck)

CPR, starting with compressions, should be initiated within 10 seconds of recognizing cardiac arrest.

Early, high-quality CPR

You are performing CPR on an 11-month-old infant. A second provider prepares to apply the AED pads, placing the pads at which locations?

-On the back between the scapulae -Middle of the infant's chest on the sternum

To open Theo's airway using the head-tilt/chin-lift technique, Amy should _________________

tilt his head slightly past a neutral position

After Ana-Lisa took over compressions, Joe and Amy worked together to operate the BVM. Joe maintained an open airway and sealed the mask with both hands in the E-C position, while Amy delivered ventilations. This is the recommended technique for operating the BVM when enough providers are available. True or false?

true This is the recommended technique for operating the BVM when enough providers are available. Although a single provider often operates the BVM, evidence shows that two providers are needed to most effectively operate the equipment. When two providers are available to operate the BVM, one provider maintains an open airway and seals the mask with both hands in the E-C position, while the other provider delivers ventilations.

A 4-year-old child is unresponsive. Her pulse rate is 65 bpm, but she is not breathing normally. Which of the following actions are appropriate?

-Deliver 1 ventilation every 3 to 5 seconds -Check the pulse and breathing about every 2 minutes

What actions did the team take to minimize interruptions in chest compressions?

-Dr. Dave and Vickie switched roles within 10 seconds during the analysis. -The team continued CPR while Vickie set up and applied the AED pads. -The compressors hovered over Olivia's chest during the AED analysis and shock. Yes, that's correct. To minimize interruptions in chest compressions: Provider continues CPR while another provider applies the pads. The compressor hovers over the infant's chest while the AED analyzes and while a shock is delivered so that they are prepared to immediately resume compressions. The providers take less than 10 seconds between role changes.

When applying the AED pads, Ana-Lisa used an anterior/posterior placement. When should providers use this placement method for a child?

-If the manufacturer recommends the use of an anterior/posterior pad placement. -If the AED pads risk touching each other. Good work! For a child, you may use an anterior/posterior placement if the pads risk touching each other or the manufacturer recommends doing so. In this case, Ana-Lisa used the anterior/posterior pad placement according to the manufacturer's recommendation.

A child is unresponsive and not breathing. You and another provider are present. You stay with the child to begin CPR. Which actions would be appropriate for the second provider to do?

-Retrieve the AED and BVM. -Activate EMS or the resuscitation team

Vickie has arrived with the AED and will now begin to use it. What are the proper steps for using an AED?

1. Vickie turns on the AED 2. Vickie attaches the AED pads while Dr.Dave continues CPR 3. Vicky says, "clear" while the AED analyzes 4. Dr.Dave and Vickie rotate positions5. Vickie hovers her hands a few inches over Olivia's chest 6. Dr.Dave says, "clear" and pushes the shock button as soon as the AED prompts 7. Dr.Dave and Vickie immediately resume CPR

You and another provider are performing CPR on an infant who is in cardiac arrest. He does not have an advanced airway in place. You demonstrate appropriate technique for high-quality CPR by performing _____ compressions and 2 ventilations.

15

During analysis, the providers will switch roles and transition to multiple-provider CPR. When Ana-Lisa takes over chest compressions, which compression-to-ventilation ratio should the team use?

15:2 That's correct! As a single provider, Amy used a 30:2 compression-to-ventilation ratio. The team arrived and prepared the BVM and AED, while Amy completed a cycle of 30 compressions. When Ana-Lisa takes over chest compressions, the team will transition to multiple-provider CPR and use a 15:2 compression-to-ventilation ratio.

You and another provider are performing CPR on a 6-month old infant. The provider performing chest compressions would use which technique?

Encircling thumbs technique

If Theo were a smaller child or toddler, Amy could use a one-hand technique to perform high-quality chest compressions. True or false?

Good work! To perform high-quality chest compressions for Theo, Amy should position one hand on top of the other with fingers interlaced and off the chest, centered on the lower half of the sternum. For a smaller child or toddler, Amy could use the one-hand technique. When using one hand, be sure you are able to compress the chest about 2 inches.

When to stop CPR?

If the team saw signs of return of spontaneous circulation (ROSC), such as spontaneous movement or normal breathing, they would stop performing CPR on Theo. Remember, you should continue CPR until: - Other trained providers arrive and relieve you. - You see signs of return of spontaneous circulation (ROSC), such as spontaneous movement or normal breathing. - You are presented with a valid do not resuscitate (DNR) order. - You are too exhausted to continue. - The situation becomes unsafe.

After determining that Theo is unresponsive, Amy must open the airway using the head-tilt/chin-lift technique and simultaneously check for breathing and a pulse. To accurately assess Theo's breathing, she should open the airway to a ________ position.

Slightly past-neutral

Based on her rapid assessment findings, Amy recognized that Theo was in cardiac arrest and initiated CPR. If Theo were unresponsive and not breathing normally but had a pulse of ≤ 60 bpm with signs of poor perfusion, which action would Amy take?

Tell Joe to get help and an AED. Begin CPR. Continue compressions and ventilations. Check the pulse and breathing about every 2 minutes.

When providing multiple-provider CPR for an infant, which compression technique should the team use?

That's correct. When multiple providers are present, use the encircling thumbs technique. Place both thumbs (side-by-side) on the center of Olivia's chest just below the nipple line. Then use the other fingers to encircle her chest toward the back, providing support.

Dr. Dave performed chest compressions at the proper depth. What is the correct chest compression depth for an infant?

The correct chest compression depth for Olivia is about 1½ inches. The correct rate of compressions is 100 to 120 per minute.

Stephanie properly opened the airway and delivered ventilations. Which statement about delivering ventilations to an infant in cardiac arrest is true?

When using a BVM, depress the bag about halfway to make the chest begin to rise. Yes, that's correct. When providing ventilations to Olivia, open the airway to a neutral position. Avoid hyperextension or flexion in the neck. When using a BVM, depress the bag about halfway to deliver a volume of 400-700 mL—enough to make the chest begin to rise. Provide smooth, effortless ventilations that last about 1 second. Minimize interruptions in chest compressions to less than 10 seconds.

If pediatric AED pads aren't available—or the AED doesn't have a pediatric setting—it's safe to use ____________ on Olivia.

adult AED pads or adult levels of energy When using adult AED pads on an infant, use the anterior/posterior pad placement.

CPR/AED protocol child

age of 1 to the onset of puberty as evidenced by breast development in girls and underarm hair development in boys (usually around the age of 12). BUT be careful because the AED pad varies by age and weight.

Use __________placement for infants with the anterior pad positioned in the middle of the chest and the posterior pad between the scapulae. Always follow the manufacturer's directions for pad placement.

anterior/posterior