Resuscitation of a Child

The following article walks you through how to provide resuscitation in a child. If you are familiar with resuscitation techniques you can use the flow diagram on the right to remind yourself of the sequence that things are done in. Try and refresh your memory once a month so that you are familiar with what to do should the circumstances require. Also, think about going on a first aid course.

We will teach a chest compression to breath ratio of 15:2 . This means that after every 15 chest compressions you should give 2 rescue breaths. Lay first-aid courses teach a ratio of 30:2 which is the same as in adults and is taught to avoid confusion. remember that doing something is better than doing nothing.

We suggest that you run through the guidelines below and then watch the video at the bottom of the page.

If a child looks as if they are not breathing – check for responsiveness. If unresponsive – Call for help

1. Airway

Ensure this is clear using the head tilt and chin lift with the head in the “sniffing themorning air” position.

Alternatively you can use the jaw thrust which is done by pushing the jaw forward in an attempt to clear the airway of any obstruction from the tongue. This is the preferred method to use in the event of trauma when it is important to keep the cervical spine immobilised.

2. Breathing

Whilst keeping the airway open, LOOK,LISTEN & FEEL.

Look for chest movement

Listen for airflow at the mouth & nose

Feel for airflow at the mouth & nose against your cheek

If there is no normal breathing, give 5 rescue breaths by pinching the nose & placing your mouth over the mouth of the child and blowing steadily to cause the chest to rise.

With a younger child you may need to place your mouth over the mouth & nose of the child,but the same principle applies, give 5 rescue breaths blowing steadily to cause the chest to rise and then fall.

3. Circulation

Check for a carotid pulse on the neck.

If a pulse is present and above 60 beats per minute you must continue to ensure that the airway is maintained and that breathing support is provided until either the child begins to breathe on their own or help arrives.

If absent use the two handed chest compression technique as part of the basic life support sequence.

Identify where the two sides of the rib cage meet. This will be the lower edge of the breast bone (sternum). Move up by one finger breadth and place the heel of one hand on the the chest at this point (you should be roughly on the lower third of the breast bone).

Interlace the fingers from your other hand and compress the chest by at least a third of the depth of the chest (approximately 5cm)

Alternate giving 15 chest compressions with 2 breaths until help arrives. If no help arrives after 1 minute you will need to activate the emergency services by dialling 999 in the UK or 112 anywhere in the world.

If the child shows signs of life you may discontinue resuscitation but ensure that you continue to maintain the airway and support breathing as required using the techniques shown above.

 

Being prepared

The Children’s e-Hospital has developed a first aid kit specifically with children in mind. This kit has over 50 parts and also includes flash cards to assist you in the event of having to deal with a choking child and other resuscitation situations

Buy a Children’s First Aid Kit

 

Authored by: Dr Tim Ubhi

Published: 8th March 2019

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