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Chest compressions in children and infants

Compression-to-ventilation ratio

  1. If single rescuer, perform 30 compressions and 2 breaths CPR (30:2)
  2. If 2 and more rescuers, perform 15 compressions and 2 breaths CPR (15:2)

Compression rate

  1. Maintain rate of 100 to 120 compression/min

Compression depth

  1. For infant: compress at least approximately 4 cm
  2. For children: compress at least approximately 5cm

Chest recoil

  1. Allow complete chest recoil for adequate blood flow into heart
  2. Avoid learning on chest between compressions

Interruptions in chest compressions

  1. Minimize interruptions to maintain good blood circulation

Chest compression technique

Children
  1. Use 1 or 2 hands
  2. Technique same as adult: heel of one hand on top of the other
  3. If child is small, 1 hand can compress the required depth
Infant
  1. 2-finger technique
    • Place infant face up on flat, firm surface.
    • Place 2 fingers at the center of chest, below nipple line.
    • Provide compressions at rate of 100 to 120/min.
    • Compress with a depth of approximately 4 cm at least.
    • Ensure complete chest recoil while minimizing interruptions of compressions.
    • Complete 30 compressions and give 2 breaths, each over 1 second.
    • Continue cycles and use AED once available.
    • Continue providing BLS until emergency services arrive or infant responds.
  2. 2 thumb-encircling hands technique – preferred when 2 or more rescuers
    • Place infant face up on flat, firm surface.
    • Put both thumbs side by side on center of infant’s chest, below nipple line. Encircle infant’s chest with remaining fingers.
    • Depress breastbone using thumb while encircling chest
    • Maintain compression rate of 100 to 120/min
    • Compress with a depth of approximately 4 cm at least.
    • Ensure complete chest recoil while minimizing interruptions of compressions.
    • Provide 15 compressions then deliver 2 breaths, each over 1 second
    • Continue 15:2 CPR cycles and use AED as soon as available
    • Continue 15:2 CPR cycles until emergency services arrive or infant responds
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