ProCPR.org

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Now for this scenario we're looking at an infant who is in cardiac arrest

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but we have two recusers to be able to do CPR.

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The setup is the same we're gonna check for scene safety, make sure personal protection equipment is on and ideally both rescuers

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will have a shield or a mask with a one way valve

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because we're going to be switching off and on between giving rescue breaths and doing chest compressions.

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Now, when you approach the patient, the first person that gets to the baby is the one who's gonna do the

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assessment, check for signs of breathing, check for pulse, and initiate the EMS call.

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Not necessarily in that order.

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The second rescuer activates the emergency medical response system and then returns as soon as possible

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or stays on scene if they've got a mobile communication device.

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As soon as they're done activating emergency medical services, we can go right into two rescuer CPR.

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So I'm going to be doing one rescuer CPR the whole time while the second rescuer is away.

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Once the second rescuer comes in, the technique changes a little bit.

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If the second rescuer is able to do thumb CPR, they are going to go ahead and reach their hands around

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the thoracic part of the body of the patient.

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while the thumbs are on the center of the sternum, between the nipples.

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Now, if you can't do that because you have problems with your thumbs or for whater reason it doesn't

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work for you, an alternative is still okay to do, the two fingers on the sternum, as a second rescuer.

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Now, one mention about the circumferential squeeze that we saw back in 2005:

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There hasn't been enough research and science to say "yes, it's a good thing" or "no, it's a bad thing."

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So, at this point, it's indifferent. They are simply deemphasizing the circumferential squeeze

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while maintaining the thumb CPR.

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So, the verdict is still out on that, they are not really voting pro or con in regards to the advantage

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of doing the thoracic squeeze, maybe more science will come down the road.

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So, he's gonna go ahead and start with his thumb CPR.

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The second thing that changes is we move from 30 compressions to 2 respirations with one rescuer CPR

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to a 15 compression to 2 respiration model.

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So, after he gets done with his 15 compressions I am going to seal the mask.

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This is an adult mask that's being improvised.

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Of course, if you have an infant sized mask it's always a good idea to match the proper equipment with the proper sized patient.

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In this case though, because these are such a common mask to use and to find, I'm going to show you how

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to improvise an adult size mask with a baby.

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You're simply gonna flip it upside-down from what it normally is with an adult, and the small narrow

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part which normally goes over the nose of the adult patient is now gonna go over the chin of the baby

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while the rest of the mask goes over the nose and the rest of the face.

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I'm going to make sure to seal the mask firmly to the face while keeping the head in a neutral position.

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The compressor is going do now 15 compressions and then after their 15 compressions,

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I am going to deliver my 2 rescue breaths to get chest rise and fall.

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2-3-4-5-6-7-8-9-10-11-12

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Up to 15 then followed by two rescue breaths. If his hands get fatigued, start to go numb,

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whatever happens happens, and he needs to switch he's just going to simply say "Switch"

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We're just going to switch. There's none of this fancy choreography any more, it's just practical, lets switch.

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So we find a good time, he fades to the back so we don't stumble over each other, switch masks.

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Then, I get in position. If he finished his 15 compressions he can go with another 2 breaths.

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Otherwise, I'm going to go right back in with 15 compressions.

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Remember, when you're up here and you're making the switch, normally the old saying used to be:

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"Give the patient a kiss goodbye."

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That was just a easy way to rememeber that when, usually, when you switch in a two rescuer CPR situation,

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you end with two rescue breaths, make your switch, come right in and then continue with your good effective compressions.

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Again, 15 compressions, a third of the depth of the full chest in depth.

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And at least 100 compressions a minute, that's more than 1 a second.

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We're going to continue this until an AED arrives or until Emergency Medical Services or advanced life support arrives to take over

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Baby Baby are you okay, are you okay?

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Doesn't appear to be breathing.

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You! Go call 911 and tell them we have an infant that's not breathing and we have two rescuers on scene.

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I don't feel a pulse, I'm going to start cpr.

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(1-2-3-4-5-6-7-8-9-10-11-12-13-14-15)

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(16-17-18-19-20-21-22-23-24-25-26-27-28-29-30)

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(1-2-3-4 Takeover compressions 10-11-12-13-14-15)

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(1-2-3-4-5-6-7-8-9-10-11-12-13-14-15)

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I'm getting really tired

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(1-2-3-4-5-6-7-8-9-10-11-12-13-14-15)

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(1-2-3-4-5-6-7-8-9-10-11-12-13-14-15)

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And we would continue this until EMS arrives or an AED arrives on scene.