Child CPR

CPR is a lifesaving procedure that is performed when a child's breathing or heartbeat has stopped, as in cases of drowning, suffocation, choking, or injuries. CPR is a combination of: Rescue breathing, which provides oxygen to a child's lungs and Chest compressions, which keep the child's blood circulating. Permanent brain damage or death can occur within minutes if a child's blood flow stops. Therefore, these procedures must be continued until the child's heartbeat and breathing return, or trained medical help arrives.

Scenario 1- A three year old Preschool student is choking on a piece of apple during the afternoon snack time. She is three years old and in Preschool room 2 at Daystar Preschool. The student is coughing and grasping at her throat. The usual recognized sign that a child is choking is when he/she grasps her throat with one or both hands. Another sign of a choking child is coughing. The best procedure for the moment is to encourage the child to continue to try to cough up the object. The child should be attended by a teacher.  If nothing comes out in a short time, call for emergency assistance. Weak coughing usually indicates that a choking child can stop breathing and lose consciousness rapidly. The teacher should give abdominal thrusts (Heimlich maneuver) until the object is coughed up. If none of the methods work, then the teacher who is qualified in CPR should begin performing CPR while someone calls for emergency assistance.

Scenario 2- A six month old infant is found unconscious in her crib located in the Infant/Toddler room at Tiny Tots Daycare. The infant is lying on her back and is not breathing. If an infant is found unconscious, the teacher should check the victim and have someone call for emergency assistance. If no one is present, then the ABCs of rescue breathing should be done for several minutes before calling for emergency assistance. The teacher should check to see if the tongue or something else is obstructing the airway. If there appears to be an obstruction, the teacher should lay the infant along their forearm with his face down, making sure that his head and neck are lower than his torso. Then using the heel of the free hand, the teacher should give the baby four or five rapid blows to the back between the shoulder blades, which should take about four or five seconds. Once the first set of back blows is done, turn the infant over, supporting the body on the teachers free forearm and the head and neck with the free hand and fingers while enclosing the child between your two arms. The teacher should then give four quick chest thrusts in the center of the infant’s breastbone with a steady, jabbing motion. If there appears to be no obstruction, then infant rescue breath should be performed. The teacher should then tilt the infant’s head back, then cover the infants nose and mouth and use a gentle puff of air that is blown from the cheeks, not the lungs. The infant should expel the air you have breathed in on his own. The teacher should watch the chest and listen to see whether breathing has resumed. The process should be repeated several times. If the infant does not resume breathing, then a check for circulation should be performed. This is done by checking the brachial artery near the arm pit, between the elbow and shoulder. Place the middle and index finger with light pressure on this artery and wait four to five seconds. If no pulse is felt, then it is necessary to perform compression on the chest. In a gentle manner, place the middle three fingers in the center of the victim’s chest between the infant’s two nipples. Tilt the neck back and lift the index finger, exercise gentle pressure about ½ to ¾ inch deep on the chest with the remaining two fingers. This should be done five times, then a rescue breathing puff should be administered. This cycle should be repeated twenty times before checking for breathing and pulse and should continue until help arrives.

In order to prevent these disasters, teachers should never underestimate what a child can do. Play it safe, and assume the child is more mobile and more dexterous than you thought possible. Think ahead to what the child may get into next, and be ready. Climbing and squirming are to be expected. Always use safety straps on high chairs and strollers. Choose age-appropriate toys. Do not give small children toys that are heavy or fragile. Inspect toys for small or loose parts, sharp edges, points, loose batteries, and other hazards. Keep toxic chemicals and cleaning solutions safely stored in childproof cabinets. Create a safe environment and supervise children carefully, particularly around water and near furniture. Dangers such as electrical outlets, stove tops, and medicine cabinets are attractive to small children.

All parents and those who take care of children should learn infant and child CPR. Time is very important when dealing with an unconscious child who is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur as soon as 4 - 6 minutes later. All teachers should have training in basic first aid and rescue breathing, and at least one teacher per site must be certified in CPR. The American Red Cross offers training in infant and child CPR. The teacher should organize for emergencies and make plans accordingly. Emergency numbers and information should be posted and easily accessible. Every early childcare program should have a comprehensive first aid kit that travels with the group if they leave the site. Every teacher should have an understanding of the 10 steps for emergency response and be able to respond in the right order.

References

CPR Child-(1 to 8 years old). (n.d.). Retrieved from Medline Plus Medical Encyclopedia: http://www.nlm.nih.gov/medlineplus/ency/article/000012.htm

Infant and Child CPR . (n.d.). Retrieved from The American Red Cross: http://www.redcross.org/portal/site/en/menuitem.d229a5f06620c6052b1ecfbf43181aa0/?vgnextoid=648946a80f2bb110VgnVCM10000089f0870aRCRD&vgnextchannel=aea70c45f663b110VgnVCM10000089f0870aRCRD

Robertson, C. (2007). Safety, Nutirtion & Health in Early Education (3rd ed.). Delmar Cengage Learning.