Resuscitation in babies and children

Distinguish two types of emergencies for baby resuscitation

First of all, one should be able to distinguish between two emergencies, because they require different measures of resuscitation in babies and children.

Respiratory arrest : If the child’s heart is still beating but has stopped breathing, the child must be given artificial respiration immediately and the heartbeat checked regularly.

Cardiovascular Arrest : Cardiovascular arrest is very rare in children, but is most common in swimming accidents . If, in addition to breathing, the heart has also stopped beating, a cardiac massage must be performed in addition to ventilation. After just three to five minutes without oxygen, the brain can suffer permanent damage.

CPR in babies: how does ventilation work?

With babies and very small children, you can cover both the mouth and nose with your own mouth, so you can ventilate both body openings at the same time. Older children and adults are ventilated either through the mouth or nose. Then the other one has to be kept closed.

Before ventilation, the child’s head must be stretched so that the tongue falling back does not block breathing. Caution: Avoid overstretching babies! A horizontal, so-called neutral position should be maintained here.

Then you open your own mouth wide, let your lips relax and close your child’s mouth or mouth and nose. Now you can start ventilation by blowing the air into the child’s mouth with little effort. If your chest rises and falls as you do this, it’s working properly. How much air is needed depends on the lung volume of the person being ventilated.

Lung volume: How much air can the lungs hold?

• Babies: a shot glass full of air
• School children: half a liter of air
• Adults: one liter of air

Tip: If the child is a bit older or a partner is available, you can practice breathing donation together! It’s not difficult at all. When both people relax, you can simply try to let air flow through your mouth into each other’s lungs. However, it will only work if the patient is completely relaxed and can let go of their own breathing!

How does cardiac massage work in baby resuscitation?

Small children and babies can be placed on a table for resuscitation, larger and therefore heavier people prefer to be placed on the floor. Beds and the like are unsuitable, the floor should be sufficiently hard.

CPR involves pressure being applied directly to the breastbone as this is where the heart is located (a common misconception is that the heart is on the left side of the chest!) . About a third of the chest is compressed. There is no need to be afraid of broken ribs: Babies and children still have very elastic bones and the risk of them breaking is very low.

Where is the pressure point?

Finding the pressure point is not difficult at all. Measuring this complicated would only waste valuable time.

• Babies and toddlers: Press with two fingers, the pressure point is in the middle of the breastbone, just below the level of the nipples.
• Kindergarten children: You press with the heel of your hand and your arm is straight. The pressure point is on the lower half of the breastbone.
• School children: You put your hands on top of each other and interlace your fingers. Now you can exert pressure with both straight arms and the heel of your hand. The pressure point is two fingers above the end of the breastbone.

Next step: alternating ventilation and pressure surges

Two ventilations and 30 pressure surges should always be carried out alternately. The smaller the child is, the faster you should press. Counting the pressure surges out loud is calming and helps to keep the beat. If the child does not regain consciousness, the resuscitation measures must be continued until the emergency services arrive.