Prepare for the unthinkable
It’s every parent’s worst nightmare: while eating breakfast in his highchair , your child begins to choke. His face turns red, his lips blue. As you frantically unbuckle his safety belt, your mind races. Do you know what to do?
Naturally, it’s difficult to think about worst case scenarios. What if he chokes? What if he is injured? What if his breathing or heart stops? As difficult as it is to fathom, understanding the risks and being prepared to respond effectively in an emergency situation can mean the difference between life and death for your child. It can also mean peace of mind for you.
Training makes a difference
Statistics show that many parents and caregivers don’t have the training to know what to do when their child has been injured. In most Canadian cities, the average ambulance response time is more than eight minutes*; meanwhile, permanent brain damage can occur four-to-six minutes after breathing stops.
“We know that injury is still the leading cause of death for children from birth to age 14, yet recent research indicates that caregivers have limited first aid skills or knowledge,” said Tracy Braun, national coordinator of first aid programs for the Canadian Red Cross.
A recent Ontario study showed that 98 per cent of children who suffer cardiac arrest die. The research points out that bystander CPR training would help reduce this mortality rate.
“Knowing what to do in the first critical moments following an incident can save a life and the ability to perform CPR increases a person’s survival rate,” said Braun. “Recent changes in CPR make this skill even easier to learn and administer.”
The critical step – injury prevention
“The most important way to keep your children healthy and safe is to realize that all injuries are preventable,” Braun clarified. “It’s important to make a child’s environment safe and limit potential injuries.”
The Canadian Red Cross trains more than 300,000 Canadians each year in first aid and CPR. They strongly recommend that all Canadians, and especially parents, enrol in a first aid course. The Red Cross Child Care First Aid and CPR course includes group discussion, demonstrations, role-playing, short lectures and lots of hands-on practice. Participants also receive an illustrated, easy-to-use manual full of useful information, which also serves as a handy take-home reference.
The Red Cross offers the following guideline for Infant CPR but cautions that proper training is the best way to ensure you know what to do if the unthinkable happens. For more information on first aid training opportunities in your community, contact your local Red Cross office, call toll free 1-800-356-3226 or visit www.redcross.ca/firstaid.
*Fitch, J. (2005) Response times: Myths, Measurement and Management. JEMS, Vol. 30, Issue 9, September.
Check the scene for danger
Check the baby by taping on the shoulder or bottom of the feet and clapping loudly
Call if the baby does not respond, have someone call EMS/911.
If you are alone with a baby, do 5 cycles of CPR first, then take the baby with you (as long as you do not suspect a head or spinal injury) to call EMS/911
1. Open the airway by tilting the head back and lifting the chin up
* Look, listen and feel for breathing for 5 to 10 seconds
2. If you do not hear breathing, Seal your lips over the baby’s mouth and nose and give two gentle breaths.
* Each breath should last 1 second, just long enough to make the chest rise.
3. If both breaths go in start CPR
* Keep the airway open by using your hand to maintain a head-tilt.
* Place two fingers in the middle of the chest just below the nipple line.
* Do 30 compressions. “Push hard, push fast.”
* Allow the chest to recoil.
Continue the cycles of compressions and breaths until help arrives.
Conscious choking baby
1. If a baby is coughing or gagging the choking is mild, do not interfere.
2. If the baby is making high-pitched noises, wheezing, can no longer make a sound or becomes too weak to cough:
* Send someone to call for help.
* Sandwich the baby between your forearms, supporting the head
* Turn the baby face down with the head lower than the body
* Lower your forearm onto your thigh. With the heel of your hand, deliver five back blows between the shoulder blades
* While still supporting the head, turn the baby face up, with your arm supported on your thigh.
* Place two fingers on the middle of the chest just below the nipple line and “push hard, push fast” 5 times.
* Repeat the back blows and chest thrusts until the object is coughed up; the baby starts to cry, or the baby becomes unconscious.
“Push hard, push fast”
Compression depths: 1/3 to ½ the depth of the chest.
Unconscious choking baby
* Check the scene for danger
* If it is safe to do so, check the baby.
* If the baby does not respond, have someone call EMS/9-1-1.
1. Open the airway using the head-tilt/chin-lift and check for normal breathing for 5 to 10 seconds:
* Look, listen and feel
2. If you do not hear normal breathing, give two gentle breaths:
* Take a normal breath
* Seal your lips tightly over the baby’s mouth and nose
* Give two gentle breaths, each breath should last one second, with just enough volume to make the chest rise
3. If the baby’s chest does not rise after the first breath, perform the head-tilt/chin-lift again and attempt to give a breath.
4. If your breath still does not go in, start CPR
* Place two fingers on the middle of the chest, just below the nipple line.
* Do 30 compressions.
“Push hard, push fast.”
Allow the chest to recoil.
5a After each cycle of compressions, look in the mouth
* Grasp both the tongue and lower jaw and lift.
* If you do not see an object, try to give a breath. If breath does not go in, go to step 4.
* If you see an object, remove it and go to step 6.
5b Slide finger down the inside of the cheek to sweep the object out.
* Give a breath. If your first breath goes in, give a second breath.
* When both breaths go in, and there is no obvious response to your two breaths, start the CPR sequence of 30 compressions and 2 breaths.
If your breath does not go in, go back to compressions.