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Pediatric Cardiopulmonary Resuscitation (CPR) according to the American Heart Association (AHA) involves specific steps tailored to infants and children up to puberty. The process begins with ensuring the scene is safe for both the rescuer and the patient. Once safety is confirmed, check the child’s responsiveness by gently tapping and shouting. For infants, you should tap the bottom of the foot. If there is no response, activate the emergency response system. If you are alone with a child or infant and there is no response, perform CPR for 2 minutes before leaving to call emergency services. If another person is present, have them call emergency services immediately.
Next, open the airway using the head-tilt-chin-lift technique. Be careful with the amount of tilt, especially in infants. Check for breathing and a pulse for no more than 10 seconds. For infants, check the brachial pulse, and for children, check the carotid or femoral pulse.
For chest compressions in infants (under 1 year), use two fingers in the center of the chest, just below the nipple line, pressing to a depth of at least 1.5 inches (4 cm) at a rate of 100-120 compressions per minute. For children (1 year to puberty), use one or two hands (depending on the size of the child) on the lower half of the breastbone, pressing to a depth of at least 2 inches (5 cm), but not more than 2.4 inches (6 cm), at the same rate of 100-120 compressions per minute.
After compressions, provide rescue breaths. For both infants and children, give 2 breaths after every 30 compressions (or 15:2 if two rescuers are present). Each breath should last about 1 second and make the chest rise visibly. Use an Automated External Defibrillator (AED) as soon as it is available. For infants and children under 8 years, use pediatric pads if available. If not, use adult pads, placing them so they do not touch each other. Follow the AED prompts and resume CPR immediately after each shock, continuing until the child shows signs of life or emergency medical personnel take over.
Continue cycles of 30 compressions and 2 breaths (or 15:2 if two rescuers are present) until the child shows signs of life, an AED is ready to use, or professional help arrives. These steps ensure that CPR provided to pediatric patients follows the AHA's guidelines for optimal outcomes.
Be great,
Evan, The Paramedic Coach
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