How to do CPR on a Child?

2011 CPR standards and techniques for child victims as recommended by the International Liaison Committee on Resuscitation (ILCOR) and provided by the following CPR providers:

  • St. Johns Ambulance
  • Canadian Heart and Stroke Foundation
  • Canadian Lifesaving Society
  • workplace approved Training

The following material is for information purposes only; if you would like to learn how to do CPR on a child, take a hands-on CPR course or re-certify your CPR “C” with a credible provider near you.

Instructions for CPR on a Child Victim

 Victim: The victim in this scenario is an unconscious, non-responsive and not breathing child. According to ILCOR and all credible CPR providers in Canada, a child is defined as someone that does not show signs of puberty. If signs of puberty are present the victim is to be treated as an adult. However, if you feel that one handed chest compressions (mentioned later in this page) is too difficult for you on this child victim, follow chest compression procedures for an adult.

1. As the rescuer enters the scene he or she must assess the scene. Surveying the scene includes checking for hazards and asking bystanders for a history on the victim.  The rescuer should also ask if the parents or guardians are present. Depending on the province and legislation candidates might not be able to help a victim without the approval of parents or guardians. If no parents or guardians are present and the victim is unconscious, consent is implied.

If dangers a present and can pose a risk to the rescuer or victim the rescuer must contact emergency medical services (EMS) and await instructions from EMS. If no dangers are present and consent has been given or implied, continue to the step 2.

2. Rescuer must check the responsiveness of the victim. Using a technique known as “tap and shout”, formerly known as “pinch and shout”, the rescuer should gently tap the child on the shoulders and speak to the victim to check for responsiveness. If the victim responds ask if he or she needs any assistance. If the victim does not respond continue to the step 3. It is important to check for responsiveness as the victim may be sleeping. The rescuer is required to tap the victim on the shoulders as the victim may be deaf.

3. The rescuer should position him/herself next to the victim’s head while on his or her knees. The rescuer should place his or her fingers under the jaw of the victim, the other palm on the victim’s forehead and gently tilt the child’s head back to open the airway. This “head-tilt-chin-lift” is designed to open the victim’s airway and allow for free movement of air through the victim. Without opening the victims’ airway the free passage of air might be blocked by the tongue or other objects preventing necessary airflow.

4. With the airway open, look, listen and feel for breathing. The rescuer should look at the victim’s stomach and chest to see if it is rising and falling and, at the same time, feel for breathing on his or her ear and listen for breathing. In order to effectively check for breathing the rescuer must place his or her ear within two or three inches of the victim’s mouth with the eyes focusing on the victim’s chest. The rescuer should check for normal breathing for no more than 5 seconds.

5. In this rescue scenario the child is not breathing. The rescuer now has sufficient information to send a bystander to contact EMS. The trained rescuer will continue with CPR as the bystander contacts 911. To effectively send a bystander to contact EMS, the rescuer must tell the bystander the following thing:

  • Point at a competent bystander and identify him or her through an article of clothing. Example: “Hey you in the grey pants”.
  • Tell the bystander to contact EMS. Example: “Go call 9-1-1”
  • Tell the bystander some information about the victim. Example: “I have a child victim that is not breathing”.
  • Tell the bystanders to report back after contacting 9-1-1 to be able to confirm that the call was made. Example: “Report back to me as soon as possible”
  • Tell the bystander to bring an automated external defibrillator (AED) with child pads and someone trained to use it. Example “Bring me an AED / Defibrillator and someone trained to use it”.
  • Finally, ask the bystander if they understand. Example “Do you understand?”

6. The rescuer must begin with chest compressions to help continue circulate oxygenated blood throughout the victim’s body. Without oxygen, the victims’ vital organs can fall victim to permanent damage. To do effective CPR, the rescuer must find the correct location to do chest compressions, otherwise known as “land marking”. The location for the chest compression on a child is the centre of the chest. To  properly land mark onto the chest the rescuer must expose the victim’s chest and place the heel of his or her hand onto the centre of the victim’s chest (approximately between the nipples). The rescuer will keep that one hand locked and begin chest compressions.  The rescuer should be on his or her knees, next to the victim’s body. The rescuer should focus all of the pressure of the chest compression onto the heel of his or her hand that made the initial land mark. With elbows locked and with his or her body overtop of the victim the rescuer will complete 30 chest compression’s. The chest compressions should be at a pace of at least 100 per minute and should compress the victims’ chest approximately ½ to 1/3 of the victims’ body. The ideal position for the rescuers’ free hand is on the victim’s forehead keeping the airway open.

7. Once the 30 chest compressions are complete the rescuer will attempt to ventilate the victim twice. If the rescuer has protective equipment he or she should ventilate using the equipment. If the rescuer has no protective equipment, he or she will plug the victims’ nose and seal his or her lips over the victims’ mouth. The rescuer will ventilate one breath, pause for one second, release the plugged nose, and ventilate a second breath with the victim’s nose plugged again. The rescuer should visually focus on the victim’s chest when ventilating. Once the chest rises from the ventilation the rescuer should stop giving air. Applying too much ventilation can have negative effects of the victim.

8. The rescuer will continue to ventilate 2 breaths and complete 30 chest compression until one of the following things happens:

  • The victims’ vitals change. Example: Victim wakes up, begins breathing or vomits.
  • The AED arrives. Once it arrives take it out of the bag and turn it on and follow the prompts.
  • Parents or guardians of the victim ask the rescuer to stop
  • Emergency medical services arrive and notify the rescuer to stop CPR.
  • The rescuer is too tired to continue CPR.

The material posted on this page is for information purposes only. To learn proper CPR it is vital that candidates learn through a “hands on” approach.

Video

Check out this new video on CPR and AED usage for adult and child victims. The instructor is a workplace approved first aid and CPR trainer.

Available Courses that Teach These Techniques 

This CPR training is covered in the following courses provided by the 4 major providers in Canada:

  • CPR level “A”
  • CPR level “B”
  • CPR level “C”
  • Health Care Provider CPR (CPR “HCP”)
  • Emergency First Aid and CPR
  • Emergency Child care first aid and CPR
  • Standard First Aid and CPR
  • Standard Child care first aid and CPR
  • Wilderness First Aid and CPR