Health Information

Cardiopulmonary Resuscitation for Infants

(Lay Rescuer CPR for Infants)

Definition

Cardiopulmonary resuscitation (CPR) is a series of steps to help a person who is not responding and has stopped breathing. CPR helps deliver oxygen rich blood to the body tissue when the body is not able to do this on its own. Infant CPR should be used in babies less than 12 months of age.
Infant Heart and Lung System
Infant cardiopulmonary system
Infant CPR can keep blood flowing to vital organs until professional help arrives.
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Reasons for Procedure

CPR is given when an infant has stopped breathing. Reasons for this may include:
The outcome will depend on the cause and how soon effective CPR was started. Many are unable to regain a normal heartbeat after it has stopped.

Possible Complications

It is possible that ribs will fracture or break during chest compressions.
Greater risk is involved if CPR is delayed or not done correctly.

What to Do

Prior to Procedure

Check for responsiveness. Tap the infant to check for responsiveness. Call the infant's name if you know it. If the infant is unresponsive, follow these steps:
  • If someone is with you, have them call for emergency medical services right away and get the automatic external defibrillator (AED). An AED is a device that delivers electric shocks to the infant's heart. If you are alone, do CPR for about 2 minutes before calling for medical help and the AED.
  • Check to see if the infant is not breathing or only gasping. If this is the case, begin CPR by giving chest compressions:
    • How to Administer CPR Infant\chest compression infant cpr.jpg Place 2 fingers on the center of the chest just below the nipple line.
    • Compress about 1-½ in (inches) in most infants. Push hard and fast at a rate of at least 100 compressions per minute.
    • Allow the chest to rise completely between compressions.
    • Minimize interruption between compressions.
    • Give 30 compressions.
  • After 30 compressions, give 2 rescue breaths:
    • \How to Images\CPR\cpr 2a.jpg Open the airway by gently tilting the head backward.
    • \How to Images\CPR\cpr 2b.jpg Cover the infant's nose and mouth with your mouth.
    • Breathe 2 puffs of air into his mouth and nose. Breathe just until you see the chest rise. Breaths should be about 1 second each.
  • If you are not trained in CPR, continue doing the chest compressions without giving rescue breaths.
  • If medical help has not been called, call after 5 cycles of CPR (about 2 minutes). Call even if the infant is responding and is breathing on his own.
  • Continue cycles of 30 compressions and 2 breaths until the AED is brought to you, medical personnel arrive, or the infant responds.
  • If another person is present, take turns doing the chest compressions to avoid getting tired. If 2 people are giving CPR, the ratio of chest compressions to breaths is 15 compressions and two breaths.
  • To use the AED:
    • Turn the AED on.
    • Attach the pads. Use the child-sized pads if available.
    • Follow the prompts. If advised, deliver the shock. If the shock is not advised, the AED will tell you to resume CPR.

How Long Will It Take?

The length of time for CPR depends on the underlying causes and response time of medical help.

Will It Hurt the Infant?

The infant is unconscious when CPR is given. The procedure does not hurt. There may be some soreness in the chest after regaining consciousness.

Post-procedure Care

The emergency team will take over care when they arrive.
The infant will need to be taken to the hospital for evaluation following CPR.

Call for Help

If an infant is unresponsive and someone is with you, have them call for emergency medical services right away. If you are alone, do CPR for about 2 minutes before calling for medical help.

RESOURCES

American Heart Association http://www.heart.org

American Red Cross http://www.redcross.org

CANADIAN RESOURCES

Caring for Kids—Canadian Paediatric Society http://www.caringforkids.cps.ca

Heart and Stroke Foundation of Canada http://www.heartandstroke.com

References

2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support. Pediatrics. 2006;117(5):e989-e1004.

Bardy, G.H. A critic's assessment of our approach to cardiac arrest. New Engl J of Med. 2011;364(4):374-375.

Bush CM, Jones JS, et al. Pediatric injuries from cardiopulmonary resuscitation. Ann Emerg Med. 1996;28(1):40-44.

Finer NN, Horbar JD, et al. Cardiopulmonary resuscitation in the very low birth weight infant: The Vermont Oxford Network Experience. Pediatrics. 1999;104(3):428-434.

Heartsaver pediatric first aid CPR AED. American Heart Association website. Available at: http://www.heart.org/HEARTORG/CPRAndECC/CorporateTraining/HeartsaverCourses/Heartsaver-Pediatric-First-Aid-CPR-AED%5FUCM%5F303745%5FArticle.jsp. Accessed March 15, 2013.

Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.. Available at: http://circ.ahajournals.org/content/122/18%5Fsuppl%5F3/S640.full. Circulation. 2010;122(18 Suppl 3):S640-S656.

Topjian AA, Berg RA, et al. Pediatric cardiopulmonary resuscitation: advances in science, techniques, and outcomes. Pediatrics. 2008;122(5):1086-1098.

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