Infant Cardiac Arrest: How To Help

Why is it important to start CPR right away for an infant experiencing cardiac arrest?

Every second counts in cardiac arrest. Recognizing cardiac arrest and activating the EMS system, immediately beginning CPR, and using an AED as soon as possible gives the infant the best chance for surviving the incident.

Is there any difference in doing breaths on an infant than on a child?

The difference is only in the head-tilt/chin-lift technique. For children, tilt the head back to a slightly past-neutral position, which is a little less than for an adult. For infants, tilt the head back to a neutral position.

Do I do chest compressions differently on a child than on an infant?

The approach is the same, but chest compressions should be modified slightly for children and infants.

• For a child between the ages 1 to 12, use both hands and compress the chest about 2 inches.
• For a smaller child, you may use one hand, instead of two hands, to give compressions.
• For an infant (under 1 year of age), compress the chest about 1 ½ inches using the two-thumb/encircling hands technique).

-Alternatively, you can use the two-finger technique to give compressions.

-If you cannot compress the infant’s chest about 1 ½ inches using the encircling hands or two-finger technique, you can use the one hand technique.

Won’t I break the infant's ribs?

You might, but don't worry about this. Remember your priority is to keep the blood circulating. A damaged rib will mend, but without chest compressions, the infant’s chances of survival are significantly reduced.

What if I do chest compressions, but the infant is still breathing?

Accidently giving chest compressions on an unresponsive infant who is breathing is not sure to create life-threatening injuries. The danger of not giving chest compressions to an infant in cardiac arrest clearly outweighs any potential risks.

How long should I do compressions for?

You should keep going until:

• You notice an obvious sign of life.
• An AED is ready to use and no other trained responders are available.
• You have performed about 2 minutes of CPR (5 sets of 30:2) and another responder is available.
• You have performed about 2 minutes of CPR (5 sets of 30:2), are alone and need to call 9-1-1.
• EMS arrive and begin care.
• You are alone and too tired to continue.
• The scene becomes unsafe.

Will I restart the heart if I give chest compressions?

Chest compressions pump a small amount of blood around the body to keep the organs—most importantly the brain—alive. Chest compressions significantly increase the possibility of the person being successfully resuscitated when emergency medical services (EMS) arrive and continue care. The chance of restarting the heart by chest compressions alone is very low. To restart, a heart usually needs an electric shock from a defibrillator.

Can I use a defibrillator?

Yes, you can use an automated external defibrillator (AED) even if not trained. When you turn on the AED, it will prompt you to the steps you should take. Many public places, such as train stations and shopping centers, now have one available.

What if the breaths do not make the chest rise?

If the first breath does not cause the chest to begin to rise, re-tilt the head and ensure a proper seal before giving the second breath.

If the second breath does not make the chest rise when beginning CPR, an object may be blocking the person’s airway.

• Immediately begin chest compressions. The chest compressions used in CPR may dislodge the object.
• Before attempting breaths again, open the mouth and look for an object in the infant’s mouth.
• If you see it, remove it with a finger sweep using your pinky finger.
• Never do a finger sweep if you don’t see an object because you might push the object further into the infant’s airway.

Does it matter where I place each of the AED pads?

It is best to place pads as indicated. But if pad placement is reversed, the AED will still work. Follow the manufacturer’s instructions.

In general, for an adult or child, place one pad on the upper right side of the chest and the other pad on the lower left side of the chest a few inches below the left armpit. If the pads touch, position one pad in the middle of the chest and the other pad on the back between the shoulder blades.

For an infant, place one pad in the middle of the chest and the other pad on the back between the shoulder blades.

Is it safe to use an AED in a pool or when the person is lying in a puddle of water? What about a metal surface?

If the infant is in water, remove them from it before using the AED. However, it is safe to use an AED in rain or snow. It is safe to deliver a shock to an infant in cardiac arrest on a metal surface as long as appropriate safety precautions are taken.

• Avoid allowing the defibrillation electrodes to contact the metal surface.
• Ensure that no one is touching the infant when the shock button is pushed.