Once you have learned the basics of the Adult CPR Guidelines, learning the few minor differences for children is easy and only takes a few moments. Having a strong foundation by learning the basics is essential. I will focus on the key differences between the adult and child guidelines. A child is considered to be between the ages of 1 and 8 years old.
Activation of EMS
With children, the majority of cardiac arrests are secondary to a respiratory complication. Therefore, when a child is initially found, the rescuer should provide 5 cycles or 2 minutes of CPR before pausing to activate the EMS system and obtaining an AED. In a hospital or healthcare environment, activation of CPR and notifying others will happen simultaneously.
Crowd control is a huge issue when a child requires assistance because everyone is curious and wants to help. In general, assign one person to be in charge of crowd control. A general rule is that if someone is not actively participating in the code, then they need to leave the area, otherwise confusion will ensue. Also, remember to assign someone to keep the parents informed, especially if they are watching the actual code, which often occurs these days. Parents are not immediately escorted out of the room anymore since there is data demonstrating that if the child does not survive, parents often cope better knowing that all efforts were made to save their child’s life. But this will vary on a case by case basis.
When performing CPR you will be providing oxygen to the brain, heart, and other vital organs. That’s why acting quickly will decrease the likelihood of organ damage from the lack of oxygen.
- For the pulse checks, the provider can check for a carotid or femoral pulse.
- For children, you will use one or two hands for compressions depending on the size of the child. The depth of the compressions will vary as well from about 1.5 to 2 inches again depending on the overall size of the child. The goal is to compress the chest by 1/3.
- The compression to ventilation ratio will be the same as an adult for a single rescuer (30:2), however if two rescuers are present the compression to ventilation ratio changes to 15:2. The goal is to do about 100 compressions a minute
Automated External Defibrillator (AED)
Apply after 5 cycles of CPR if there is no response.
- Use the pediatric sized pads. If no pediatric pads are available, you may use the adult pads.
Reviewing this information frequently will provide you with the confidence to respond quickly during an emergency. As you prepare for your NCLEX-RN, make sure you study hard and often — it will pay off in the end.