In October 2010, the American Heart Association released updated guidelines for performing cardiopulmonary resuscitation (CPR). The new CPR guidelines are applicable for adults and children 3 months of age and older.
The three basic parts of the new CPR procedure are referred to as the "CAB sequence." The letters C-A-B stand for the following:
- Circulation (Chest Compressions)
- Airway (Clear the Airway)
- Breathing (Perform Rescue Breathing, also called Mouth-to-Mouth Resuscitation)
Before beginning CPR, make sure that the child is in a safe area (i.e., away from live power lines, out of a busy street) and determine if he or she is breathing and responsive (i.e., able to talk, open his or her eyes, or move his or her legs). If neck injury is possible, do not move the child unless it is absolutely necessary.
Gently shake the child's shoulders or chest and loudly ask, "Are you okay?" to get a response. If the child is severely injured but is breathing and responsive, do not begin CPR and call 911 for medical assistance. If the child is not breathing and does not respond, administer chest compressions at the rate of at least 100 per minute for about 2 minutes, call 911, and then continue chest compressions.
If you have been trained in CPR, assess the child's airway to make sure it is not blocked and check his or her breathing. Look into the child's mouth and throat for an obstruction; listen for breath sounds; and use your cheek to feel for air movement from the child's nose and mouth. Lift the child's chin to tilt the head back and open the airway. However, do not move the child's head if neck injury is possible.
If you can see an obstruction in the airway and are able to reach it easily, remove it using your fingers. If not, do not sweep your fingers through the child's mouththis can force the obstruction further into the child' airway. Perform back blows and chest thrusts (in children under 1 year of age) or the Heimlich maneuver (in children over the age of 1) to dislodge the obstruction.
To perform back blows, hold the infant face down across your forearm and strike the middle of the back as many as five times using your free hand. If back blows do not dislodge the obstruction, turn the infant over and administer chest thrusts (press sharply on the center of the chest as many as five times using two or three fingers). Alternate back blows and chest thrusts until the obstruction is dislodged. If the infant does not begin breathing, call 911 and begin chest compressions and rescue breathing.
To perform the Heimlich maneuver, wrap your arms around the child's waist (below the breastbone and above the navel). Make a fist with one hand, grasp your fist with your other hand, and administer quick, upward thrusts to dislodge the obstruction. If the child does not begin breathing, call 911 and begin chest compressions and rescue breathing.