Document Sample


Why learn CPR
Going to CPR Class
What to do
Definitions: apnea, bradycardia, cyanosis
Quick review
A note

1. It is important for all parents to learn Cardiopulmonary Resuscitation (CPR) in the
   event their own infant or another infant stops breathing.
2. Accidents and illness occur in childhood and we believe parents feel more confident
   when prepared to deal with emergencies.
3. In any situation when a baby is not breathing and/or the heart rate is low (less than
   80 bpm) you will need to start CPR.

1. CPR classes are held in the NICU Classroom two (2) times a week. There is no charge
   for the class.
2. We suggest all parents attend the CPR class while their baby is in the hospital.
3. Family members and other adults who will be caring for your baby are encouraged to
   take the infant CPR class.
4. It is helpful to read a CPR handout or view a CPR film before going to class.
5. Try to attend class before you room-in with your baby.
6. Please speak to your baby’s nurse or the NICU Case Manager (Social Worker or
   Registered Nurse) to schedule a CPR class.

1. Call for help! Someone may be home or around who can call for additional help or
   relieve you if you tired.

                                                                                 CPR 1
2. Stimulate the baby. Gently rock him on a firm surface and flick his foot. Do Not
   shake your baby. Shaking him could seriously injure his neck. (See Figure A & B)

                   Figure A                                    Figure B

Suction the baby with the bulb syringe.
1. Suction his mouth first and then the nose. The mouth is suctioned first to prevent
   the baby from breathing mucus or formula into the lungs as the baby begins to gasp
   when breathing resumes.
2. Suction as far back in the throat as the bulb syringe will easily reach.
3. If a bulb syringe is not available, use your finger to wipe away any milk, mucus or
   other material you see in his mouth. (See Figure C & D)

                   Figure C                              Figure D

Position the baby on his back on a hard flat surface.
1. Hold the baby’s head with your hand around the jaw with the tip of his nose pointed
   straight up. (see Figure E & F)
2. Hold the jaw forward with the fingers of one hand. Bending the head forward or too
   far back blocks air from entering the lungs.
3. You may use a diaper or blanket under the shoulders to raise the shoulders up about
   1 inch.

                                                                               CPR 2
            Figure E                                      Figure F

1. Give the baby two (2) slow breaths (1-1½ seconds each). Place your mouth over
   the baby’s nose and mouth.
   a. Give him 2 slow soft puffs with the air in your mouth to fill his lungs (see Figure
   b. Look out of the corner of your eye to see the baby’s chest rise like an “easy
      breath” when you breathe into the baby.

                                Figure G

2. If you did not see the chest move, the breathing passage is blocked. To remove an
   object blocking the windpipe:
   a. Turn the baby across your arm in a head-down position. The baby’s head is lower
      than his bottom
   b. Give 5 brisk blows between the shoulder blades. (see Figure H)

                                                                                 CPR 3
                                      Figure H

   c. Turn the baby over (onto his back) and give 5 chest thrusts (position your fingers
      like for chest compressions (see Figure I)

                               Figure I

   d. Look in his mouth. If you see the object, remove it with your finger. Do not put
      your finger in his mouth unless you see the object.
   e. Position the baby on his back and give him 2 more quick puffs. If the chest still
      does not move after the puffs, repeat the procedure (turn the baby over and give
      5 back blows; turn the baby over and give him 5 chest thrusts; etc) until the
      chest rises.
3. Ask yourself two important questions:

   Is the baby breathing?
   Is there a heart rate?

1. Ask these two questions about every minute and then do only what the baby is not

                                                                                CPR 4
2. Check for breathing by watching or feeling the chest move or listening and feeling
   the baby’s breath over his nose and mouth. (Figure J)

                                       Figure J

3. Check the heart rate by feeling the pulse inside his arm opposite the elbow. (see
   Figure K & L)
4. Feel for the pulse for 5 seconds.

             Figure K                               Figure L

5. If you feel a heart beat but the baby is not breathing:
   a. Place your mouth over the baby’s nose and mouth. Give him 1 quick puff with the
      air in your mouth to fill his lungs. Look out of the corner of your eye to see the
      baby’s chest rise like an “easy breath” when you breathe into the baby
   b. Count to 2: then give the baby another breath
   c. Count and breathe for 1 minute:
              1-2-breathe; 1-2-breathe.
              (about 20 breaths a minute)
   d. Ask the two questions again
   e. Do what the baby is not doing.

                                                                                 CPR 5
1. If the heart rate is low (less than 80 bpm) or if there is no heart rate, press
   on the chest and breathe for the baby. A simple way to count the heart rate
   is to feel the pulse for 6 seconds and multiply the number of beats you count by
   a. Place your fingers one finger width below the nipple line on the breastbone

                                Figure M

   b. Press down ½ to 1 inch with the tips of your middle finger and ring finger with
      your hand straight up. It is easier to use your right hand if you are right-handed;
      the left hand if you are left-handed. The tips of the two fingers should remain
      on the breastbone. Do not lift your fingers up after pressing and releasing (see
      Figure N)

                                        Figure N

      1            2            3            4            5            breathe

      press        press        press        press        press        breathe

                                                                                 CPR 6
   c. This is about 100 times a minute. The breath is about 1-1½ seconds long.

2. Stop and ask the two questions each minute.
      Is the baby breathing?

      Is there a heart rate?

      Do only what the baby is not doing.

3. Continue CPR until your baby responds or help arrives. Always call the doctor if your
   baby has a breathing problem or turns blue.

 Apnea: Lack of breathing for 15—20 seconds.
 Bradycardia: Slowing of the heart rate, usually less than 80-100 beats in a minute in
  the newborn.
 Cyanosis: A blue or blue/gray color. Most easily seen on the tongue, lips, and inside
  the baby's mouth.
 CPR: Cardiopulmonary Resuscitation.

1. Stimulate—Rub the baby’s back or slap the baby’s heels
2. Suction—mouth then nose (may use your finger to clear the mouth).
3. Position—nose straight up.
4. Breathe—2 slow breaths.
5. If chest does not move—reposition your baby’s head and try to give breaths again.
6. If chest does not move—give 5 back blows; then 5 chest thrusts.
   Give 2 slow breaths to check if windpipe is clear. Repeat until object comes out and
   windpipe clears.
7. ASK:             Is the baby breathing?
                    Is there a heart rate?

8. If there is a heart rate: breathe for the baby. Count:        1-2-breathe
9. If the heart rate is low (less than 80 bpm) or if there is not a heart rate: breathe &
   press on the chest.

                                                                                 CPR 7
      1              2               3            4        5           breathe

       press         press           press        press    press       breathe
                                     (press=½ to 1 inch)

10. Continue CPR until help arrives or baby begins to breathe and he has a heart rate.

A NOTE: This is not a “certified” CPR course. It clearly and simply teaches you to
resuscitate your infant. If you wish further training, Please contact the American Red
Cross or American Heart Association.

4/98, 3/01, 3/03, 8/05, 5/07, 1/10

                                                                                 CPR 8