As a medical provider or caregiver, it’s important to understand how the American Heart Association (AHA) defines a child in terms of Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) care. Proper identification of an infant, child, or adult patient can help guide you in giving the most appropriate emergency care in a cardiac arrest situation.
What Defines a “Child” in CPR/AED Guidelines?
In CPR and AED care, a “child” refers to anyone between the ages of 1 and puberty. According to the American Heart Association (AHA) guidelines, this age group includes anyone who hasn’t yet reached adolescence or shown physical signs of puberty, like muscle development and other bodily changes. This definition is important because the approach to CPR and AED use differs significantly between infants, children, and adults.
Why is it Important to Define “Child” in CPR/AED Care?
The main reason for defining a child is to apply the appropriate amount of force during chest compressions and to set the AED appropriately. Incorrect techniques can cause harm instead of helping in resuscitative efforts. A child’s smaller frame and developing organs are not suited for the same compressive force used on adults.
Child CPR Differences vs. Adult CPR
1. Compression Depth and Technique
- Child: Chest compressions should be about 2 inches (5 cm) deep, using one or two hands, depending on the child’s size.
- Adult: Chest compressions for adults should be at least 2 inches deep, and both hands are used for compressions.
2. Compression-to-Breath Ratio
- Child: The compression-to-breath ratio for a single rescuer is 30:2 (30 compressions and 2 rescue breaths). If there are two rescuers, the ratio becomes 15:2.
- Adult: For adults, the ratio remains 30:2 regardless of the number of rescuers.
3. AED Pad Placement
- Child: For children under 8 years old or weighing less than 55 pounds (25 kg), pediatric AED pads are used. The pads are placed on the child’s chest and back (anterior-posterior positioning).
- Adult: AED pads for adults are placed on the upper right chest and lower left side of the chest.
AED Use in Children: Special Considerations
Using an AED on a child requires some special precautions and steps to ensure safety and efficacy. Here’s what you need to know:
Pediatric AED Pads
Most modern AEDs come equipped with pediatric pads, which reduce the energy of the shock delivered. Pediatric pads are crucial for children under 8 years or weighing less than 55 pounds. However, if pediatric pads are not available, adult pads may be used, though care must be taken to avoid placing them directly over the heart.
AED Shock Adjustments
For children, AEDs automatically adjust the energy level when pediatric pads are used. This helps to avoid the risk of delivering too strong of a shock, which could damage a child’s developing heart and other organs.
How to Use an AED on a Child
- Turn on the AED and follow the device’s voice prompts.
- Place the pads on the child as directed.
- Ensure no one is touching the child before delivering a shock.
- Resume CPR immediately after the shock if advised, and continue until help arrives.
When to Use an AED
If a child is unresponsive and not breathing, it is time to use the AED. The device should be applied as soon as possible, ideally after one cycle of CPR (30 compressions and 2 breaths).
Also read: What Is the Target Rate for Chest Compressions for Children?
CPR for Children: Step-by-Step Guide
When you encounter a child who is unresponsive, it’s important to act quickly and confidently. Here’s a step-by-step guide:
Step 1: Check Responsiveness
Tap the child and shout to see if they respond. If there is no response, call for help and send someone to get an AED.
Step 2: Open the Airway
Tilt the child’s head back slightly and lift the chin to open the airway.
Step 3: Check for Breathing
Look for any signs of breathing for no more than 10 seconds. If the child is not breathing, begin CPR.
Step 4: Begin Chest Compressions
- Place one or two hands in the center of the child’s chest.
- Compress the chest about 2 inches deep at a rate of 100-120 compressions per minute.
- Allow the chest to fully recoil between compressions.
Step 5: Give Rescue Breaths
- After 30 compressions, give 2 rescue breaths.
- Pinch the nose, cover the mouth, and blow gently into the child’s mouth until you see the chest rise.
Step 6: Continue CPR
Continue cycles of 30 compressions and 2 breaths until the AED arrives, emergency help takes over, or the child starts to move and breathe.
Related Post: Steps for Pediatric Out of hospital Chain of Survival
Conclusion
Defining a child in terms of CPR/AED care is crucial for providing safe and effective emergency treatment. Understanding these age-appropriate techniques and taking action when needed can significantly increase a child’s chance of survival. Whether you’re a parent, teacher, or simply a concerned bystander, knowing the distinctions in CPR/AED for children empowers you to help a young life in an emergency.
