How to do CPR on a Infant?

2011 CPR standards and techniques as recommended by the International Liaison Committee on Resuscitation for “lay person” infant CPR. The material posted on this page is for information purposes only. The following CPR providers follow the CPR techniques posted on this page:

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

Victim: The victim in this scenario is an infant that is unconscious, non-responsive and not breathing.

Step by Step Techniques for CPR on an Infant Victim

Note: Infant CPR (included in CPR level “C” courses) should only be applied to victims 12 months of age or younger.

1. As the rescuer enters the scene he or she must survey the scene. Surveying the scene includes checking for hazards and asking bystanders for a history on the victim and asking for the parents of the victim. With the victim being an infant, rescuers must have consent from the parents, guardians or care-givers of the infant. If no parents or guardians are present consent is applied. If guardians are present and no consent is given the rescuers can not continue.  To ask for consent the rescuer should attempt to introduce her him self and ask for permission from the guardians. Example:

“Hello, my name is (rescuers name) and I am a trained in first aid and CPR. Can I help save your infant?”

If dangers are present and can pose a risk to the rescuer or to the victim, the rescuer must contact 9-1-1 and await instructions from emergency medical services. If no dangers are present, if no guardians are present or if consent is given proceed to the next step.

2. Rescuer must check the responsiveness of the infant. Using a technique known as “tap and shout”, the rescuer should gently tap the infant on the feet or tickle the feet and speak or clap around the victims’ ears. If the victim does not respond or show signs of consciousness, continue to the next step.

3. The rescuer should position him/herself next to the infants’ body while on his or her knees. The rescuer should place his or her fingers gently under the jaw of the victim, the other palm on the infants’ forehead and gently tilt the victims head back to open the airway. The rescuer should tilt the infants head back so that its chin and nose are parallel to the floor. This position is also called the “sniffing position”.  This “head-tilt-chin-lift” is designed to open the victim’s airway and allow for free movement of air through the infant victim.

4. Keeping the airway open, the rescuer will look, listen and fell for breathing. The rescuer will look at the infants’ stomach and chest to see if it is rising and falling, will 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 one or two inch’s of the victim’s mouth and nose with the eyes focusing on the victims’ stomach and chest. The rescuer should check for normal breathing for no more than 5 seconds.

5. In this rescue scenario the infant victim is not breathing. The rescuer will relay this information to a bystander to contact EMS. The trained rescuer will continue with CPR as the bystander contacts EMS. To effectively send a bystander to contact EMS the rescuer must tell the bystander the following thing:

  • Point at the bystander and identify him or her through an article of clothing. Example: “Hey you in the green shirt”.
  • Tell the bystander to contact EMS. Example: “Go call EMS”
  • Tell the bystander some information about the infant victim. Example: “I have an unconscious, non-breathing infant victim”.
  • Tell the bystanders to report back after contacting EMS to be able to confirm that the call was made and when EMS is arriving. Example: “Report back to me as soon as possible”.
  • Tell the bystander to bring an automated external defibrillator (AED) with paediatric pads and someone to help use it. Example: “Bring me an AED / Defibrillator with paediatric pads and someone who is trained to use it”.
  • Finally, ask the bystander if they understand. Example: “Do you understand what I have told you?”

To recap, the rescuer should point at a bystander at say:

“Hey you, in the green shirt, go call EMS. I have an unconscious, non-breathing infant victim. Bring an automated external defibrillator or AED and someone trained to use it. Do you understand? Report back to me ASAP once you are done”.

If the bystander has difficulty with the request or if the rescuer is not sure the bystander can complete the task select more bystanders to assist or do the same thing. When in doubt the rescuer can send more bystanders.

6. The rescuer must begin with chest compressions to help circulate oxygenated blood throughout the infants’ body. Without oxygen, the victims’ vital organs will circum to permanent damage. To do effective CPR, the rescuer must find the correct location to do chest compressions, otherwise known as “land marking”. To properly land mark onto the chest the rescuer must expose the infants’ chest and place two fingers just below the nipple line of the finger. The ideal two fingers to use are the index finger and the middle finger.  Only one hand is necessary to do chest compression’s. The rescuer can use the other free hand to keep the victims’ airway open and in the “sniffing position”. During CPR, the rescuer should be on his or her knees, next to the victim’s body. The rescuer will complete 30 full and fast chest compressions. 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 depth of the infants’ body.

7. Once the 30 chest compressions are complete the rescuer will attempt to ventilate the victim twice with a one second pause between breaths. 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 seal his or her mouth over the infants’ mouth and nose. The rescuer will ventilate one breath, pause for one second and ventilate a second breath. It is important that the rescuer only apply a small amount of air. Many providers teach rescuers to apply only a “puff” of air or enough air to blow out a single candle. The rescuer should focus on the victim’s chest when ventilating. Once the chest rises from the ventilation the rescuer should stop ventilating. The rescuer should be careful not to breathe too much air into the victim as it can cause regurgitation or serious complications.

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, crying or vomits.
  • The guardians or parents arrive and ask the rescuer to stop.
  • The AED arrives with paediatric pads. Once it arrives take it out of the bag and turn it on and follow the prompts.
  • EMS arrives and notifies the rescuer to stop CPR.
  • The rescuer is too tired to continue CPR.

*Note

  • Different CPR techniques are performed if the victim has a suspected spinal injury.
  • Additional training is required for victims that regurgitate or vomit during 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 by taking a course with credible CPR provider.

Video

Check out this video on the latest infant CPR techniques provided by a trained workplace approved instructor:

CPR Training

The following Courses include infant CPR:

  • CPR level “C”
  • Standard first aid and CPR level “C”
  • Emergency first aid and CPR level “C”
  • Health care provider CPR (CPR “HCP”)
  • Standard first aid and CPR HCP