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When Giving Chest Thrusts to an Infant, To Which Depth Should I Press?

According to the American Heart Association (AHA), you should press about 1.5 inches (4 cm) or ⅓ of the chest’s depth when giving chest thrusts to an infant. This recommended depth is both safe and effective for generating enough pressure to clear an airway obstruction or circulate blood while minimizing the risk of injury.

Key Guidelines:

  • Pressing Depth: 1.5 inches (4 cm).
  • Hand Placement: Use two fingers (usually the index and middle fingers) just below the infant’s nipple line on the sternum.
  • Technique: Ensure that the thrusts are quick and firm but controlled, with the goal of applying steady pressure without causing harm.

Why is 1.5 Inches the Optimal Depth in Infants?

Pressing to a depth of 1.5 inches is enough to create the necessary internal pressure in the chest cavity to push out the object that’s causing the airway blockage. Anything shallower might not generate enough force, while pressing deeper can lead to injury, such as broken ribs or damage to internal organs, which is a significant concern in infants due to their fragile skeletal structure.

When Are Chest Thrusts Appropriate for Infants?

As per the American Heart Association’s guidelines for infant CPR, chest thrusts should only be used on infants under 1 year old if the infant is choking and unable to make coughing sounds. If the infant is coughing, encourage them to continue coughing by patting their back firmly. If the infant cannot breathe, cough, or make any sounds, then chest thrusts are appropriate to help dislodge the object and restore airflow.

Step-by-Step Guide to Giving Chest Thrusts to an Infant

Now that you understand the importance of depth in chest thrusts, let’s break down the procedure step by step for both choking and CPR situations.

1. Chest Thrusts for Choking in an Infant

  • Step 1: If you notice the infant is unable to cough, cry, or breathe, lay the baby face down on your forearm, supporting the head with your hand. Keep the infant’s head lower than the chest.
  • Step 2: Give five firm back blows between the shoulder blades using the heel of your hand.
  • Step 3: If the object does not come out, turn the infant onto their back, supporting their head and neck.
  • Step 4: Use two or three fingers placed just below the infant’s nipple line at the center of the chest.
  • Step 5: Press down to a depth of approximately 1.5 inches (4 cm), ensuring each thrust is quick and sharp.
  • Step 6: Repeat alternating back blows and chest thrusts until the object is dislodged or the infant starts coughing, crying, or breathing.

2. Chest Compressions During Infant CPR

  • Step 1: If the infant is unresponsive and not breathing, lay them on a flat, firm surface.
  • Step 2: Place two fingers at the center of the infant’s chest, just below the nipple line.
  • Step 3: Press down to a depth of about 1.5 inches (4 cm) and allow the chest to fully recoil between compressions.
  • Step 4: Perform chest compressions at a rate of 100 to 120 compressions per minute. For every 30 compressions, provide two breaths using mouth-to-mouth or a bag-mask device, if available.
  • Step 5: Continue CPR until emergency medical services arrive or the infant begins to show signs of recovery.

Common Mistakes to Avoid When Giving Chest Thrusts to an Infant

Even well-intentioned rescuers can make mistakes when performing chest thrusts, especially in high-pressure situations. Being aware of these common errors can help ensure you’re delivering the best possible care:

1. Pressing Too Deep or Too Shallow

As mentioned, the recommended depth for chest thrusts is about 1.5 inches to maximize safety and effectiveness. Pressing beyond this depth can cause fractures or internal injuries, and pressing too lightly may not be effective.

2. Inconsistent Pressure

It’s important to apply consistent pressure during each chest thrust. Erratic or uneven pressure reduces the efficiency of the maneuver and may lead to unnecessary harm.

3. Failing to Allow Recoil

During compressions or thrusts, make sure the chest fully recoils before pressing again. This allows the heart to refill with blood between compressions, improving the overall effectiveness of CPR or choking interventions.

Act with Confidence, but Follow the Guidelines

As a parent, caregiver, or healthcare professional, knowing how to give chest thrusts to an infant can be life-saving during an emergency. Acting confidently is important, but following the established guidelines, including pressing to the correct depth, is equally crucial to saving a young life. This knowledge ensures you apply enough force to be effective at recovering from airway obstructions.

FAQs About Giving Chest Thrusts for Infants

Can I perform chest thrusts if I’m alone?

Yes, you can perform chest thrusts on an infant if you’re alone. However, it’s also important to call for emergency help as soon as possible.

Can I use abdominal thrusts on an infant?

No, abdominal thrusts (the Heimlich maneuver) should never be used on infants due to their size and anatomy.

Can chest thrusts harm an infant?

Yes, if chest thrusts are performed incorrectly, it can cause injuries like fractured ribs or internal damage. Following the recommended depth of 1.5 inches minimizes this risk.

What should I do if the infant becomes unresponsive after chest thrusts?

If an infant becomes unresponsive, stop giving chest thrusts and immediately begin CPR. Continue CPR until medical help arrives.

 

 

Author

LT. Jeff Haughy

Owner Jeff Haughy has been providing high-quality care in the EMS industry since 1995 and started his Fire Service career with the Alameda Fire Department in 1991 as a Fire Explorer.

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