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Reviewed by the Faculty of Harvard Medical School

Administering CPR To An Infant

CPR — cardiopulmonary resuscitation — is a basic lifesaving technique used when breathing stops and/or the heart no longer beats. In children, CPR is rarely needed for heart problems. More often it is needed for breathing problems due to choking, smoke inhalation, lung disease such as asthma, accidents or drowning.

To enroll in a CPR course, contact your local office of the American Red Cross or American Heart Association. While this article cannot take the place of a CPR course, here is an overview of the basic steps in performing CPR on an infant:

  • Assess And Get Help. The first few seconds should be used to figure out whether the child is unresponsive. To do this, call out the child's name, clap, gently tap his shoulder, or rub his back or chest and watch for any reaction. If you get no response, shout for help and proceed to check for breathing. If you are not alone, have someone else dial 911.
  • Position The Baby. Place the baby on his back on a flat surface such as a table or the floor; otherwise hold the baby over your thigh. If the child has injured himself, be careful when moving him. It is always best to support the head and neck.
  • Open The Airway. Place one hand on the infant's forehead and the other under his chin. Slightly tilt the head back to open the airway by lifting the chin up and out while pushing down on the forehead; an infant's head should not be tilted as much as an adult's
  • Check For Breathing. Turn your head toward the infant's chest. Look for chest movement. Place your ear and cheek over the infant's nose and mouth to listen for or feel any breathing. Watch for chest movement. If you can see, hear or feel the baby breathing, help him maintain an open airway but do not start rescue breathing. If the baby is not breathing, begin rescue breathing.
  • Perform Rescue Breathing. If the infant is not breathing, keep the head tilted. Take a deep breath then place your mouth over the baby's nose and mouth, making a tight seal, and give two slow breaths (each about one and one-half to two seconds long). Repeat for two to five breaths. Watch for the baby's chest to rise with each breath, and end the breath once you see the chest rise. If the chest does not rise, re-position the head to make sure the baby's airway is open, and again try to give a breath. If the chest still does not rise, the infant may be choking.
  • Check For Signs Of Circulation. Signs of circulation include normal breathing, coughing or movement. (Health-care providers should check for a pulse on the brachial artery, inside of the upper arm about halfway between the elbow and the shoulder.) If there are signs of circulation, but the infant is not breathing, continue rescue breathing — one breath every three seconds. If there is no sign of circulation, begin chest compressions.
  • Compress The Chest. Wrap your hands around the infant's chest, with your thumbs over the breastbone, about one-half inch below the nipples. Compress the chest with your thumbs using your hands as a firm surface to push against. If the baby is lying on a firm surface, place the middle and ring fingers of one hand on the lower half of the breastbone, about half an inch below the nipples. (Your other hand should be pressing down on the baby's forehead to make sure the airway remains open.) With either technique, push in a downward motion toward the baby's back approximately one-third to one-half the depth of the chest (about one-half to one inch). You should compress at a rate of at least 100 times per minute — or about five compressions every three seconds — in a smooth fashion. After every five compressions, give the baby one rescue breath.
  • Repeat Five Compressions And One Breath. Give one rescue breath after every five compressions. Count out loud as you do this: "one, two, three, four, five, breathe."
  • Call For Help After One Minute. If you are alone and cannot send another person for help, perform CPR for about one minute (20 cycles of five compressions and one breath). Then call 911 or your local emergency number. Resume CPR as soon as possible after calling for help.
  • Check For Return Of Breathing Or Signs Of Circulation. Every minute or so, check for signs of circulation and breathing. If there is no sign of circulation, continue chest compressions and rescue breathing. If circulation has returned but there is no breathing, continue rescue breathing with with one breath every three seconds (20 breaths per minute). Continue to monitor circulation and breathing until emergency personnel arrive.

Last updated March 11, 2008




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