Cardiopulmonary resuscitation of a child

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Performing cardiopulmonary resuscitation by cardiac arrest witnesses is associated with a better neurological outcome in both adults and children.

From this article you will learn when to call for help so that the time spent on calling for help does not limit the effectiveness of our actions, you will learn the procedure for giving rescue breaths to a child and an infant, and where to squeeze the children's chest, and whether AED can be used to help children.
  • Unfortunately, the time to implement CPR procedures is to the detriment of the patient. There is a risk of permanent damage to the brain structures. On the other hand, the lack of securing the support of another person carries the risk of providing this help alone, which may also be less effective compared to the assistance provided by several rescuers. I will now present you with several developed procedures confirmed by relevant statistics on the survival rate of children in a state of immediate threat to life. By following them you will give the injured child the best chance of survival. When there is more than one rescuer • one of them starts resuscitation, • the second one calls or goes for help. When there is only one rescuer he resuscitates for about a minute or 5 cycles, and then goes to help. To minimize the duration of the CPR break, it is possible to transfer a small child to a place where he can call for help. When there is one rescuer and before his eyes there is a sudden loss of consciousness in a child and he has information suggesting the existence of a primary cardiac cause of cardiac arrest, you should call for help first, and then start cardiopulmonary resuscitation, because in this case the child will most likely required urgent defibrillation. Remember, however, that such situations are extremely rare.
  • During an adult first aid course, you probably learned or learned that you can refrain from giving rescue breaths for your own safety. This is true. Remember - the safety of the rescuer is the most important and it is legally protected. Nevertheless, providing first aid to children arouses greater compassion in people who provide this help, because children are associated with innocence and appropriate psychological mechanisms prevail. Of course, the risk of contagion, and further infection of the rescuer when helping children is the same as when helping an adult. In this case, it is still a decision of the rescuer whether to decide to give these breaths or not. Should be returned attention to the fact that it is better to use rescue breaths during resuscitation in children, because most cardiac arrests in children result from asphyxia as a result of blockage of the respiratory tract, which in short could colloquially be called asphyxiation. Asphyxia entails the need for ventilation for resuscitation to be effective. Now you understand the essence of giving rescue breaths and the risks associated with this procedure. If you decide to give rescue breaths, it is important to do it correctly. I will now show you the procedure giving rescue breaths to a child and an infant. First a child. • Ensure that the head is tilted and the lower jaw is raised. • Pinch the soft parts of your nose with your thumb and forefinger. • Open your child's mouth, but ensure that the lower jaw is raised. • Breathe in, seal your child's mouth tightly, making sure there is no air leakage. • Breathe out slowly into the child's mouth for approximately 1 second while observing the rise of the chest. • Keeping your head tilted and the jaw raised, move your mouth away from your baby's mouth and watch your chest fall as you breathe out. • Take a breath again and repeat the described sequence five times; assess the quality of your breath by observing your child's chest - it should rise and fall as if you were breathing normally. Giving rescue breaths to a small child or baby. • Make sure the head is in a neutral position, because when a small baby lies on his back, the head is usually bent and may require a slight deflection (a rolled towel / blanket tucked under the upper torso can help maintain proper position); lift the jaw. • Breathe in, seal your mouth and nose tightly with your mouth, making sure there is no air leakage. If the older baby cannot embrace the mouth and nose, the rescuer may try to cover his mouth either the mouth or the nose of the baby (if only the nose - you should pinch your mouth so that air does not escape). • Slowly blow air into the baby's mouth and nose for 1 second, enough to visibly raise the cage. • Keeping your head tilted and the jaw raised, move your mouth away from the victim's mouth and watch your chest fall as you breathe out. • Take in the air again and repeat the sequence five times. If it is difficult to breathe effectively, it may mean that the airway is obstructed. If so, then: • Open the child's mouth and remove any visible obstacles from them; don't try to delete foreign body blindly. • Adjust your head. • Make sure the head is tilted correctly, the lower jaw is raised, and the neck is not excessively bent. • If bending your head and raising your lower jaw doesn't open your airways, try using the lower jaw extension method. • Make up to five attempts to obtain effective breaths, if they are still unsuccessful, begin compressing your chest.
  • In children, the lower half of the sternum should be pressed. To avoid epigastric compressions, locate the xiphoid process by finding a place where the lower ribs attach to each other. Place the wrist of one hand on the sternum, one finger wide above the xiphoid process. It is necessary to lift your fingers to make sure that your child's ribs are not pinched. Stand upright over the victim's chest, straighten arms and apply pressure. Compress so that the sternum is lowered by at least one third of the anterior posterior size of the chest or by 5 cm. Completely release the pressure and repeat the compressions at a frequency of 100-120 / min. After 15 compressions, tilt your head, lift your lower jaw and take two effective breaths. Continue compressions and breaths in cycles of 15 compressions for two inspirations. For larger children or finely built rescuers, this will be easier to do with two hands with laced fingers. Baby's chest compressions. The place of chest compression remains unchanged. Press the lower half of the sternum. To avoid epigastric compressions, locate the xiphoid process by finding a place where the lower ribs attach to each other. In the case of chest compressions led by one rescuer, it is recommended to perform this procedure with two fingertips. If there are two or more rescuers, use the two thumbs and hands technique that covers the infant's chest. Place your thumbs side by side in the lower half of the sternum, with their ends facing the baby's head. The remaining outstretched fingers of both hands cover the lower part of the chest, and the tips of the fingers support the back of the infant. In both methods, the lower sternum should be compressed to lower the sternum by at least one third of the anterior posterior size of the chest. Do not stop CPR until: • Return of signs of life in the child (he will start to wake up, move, open his eyes and begin to breathe properly). • The arrival of qualified medical personnel who can help or take resuscitation. • Loss of strength.
  • Cardiopulmonary resuscitation should be continued until someone with AED arrives. If this happens, connect the AED and follow the voice instructions given by the device. Remember to prioritize proper CPR over the use of AED. The defibrillator is used to "reset" an abnormal heart rhythm. Contrary to popular belief, it does not serve to restore heartbeat after its complete cessation. That is why the basic task of the rescuer is to mechanically compress the heart muscle to give the AED a chance for correct diagnosis and possible shock. Only the correct application of chest compressions can result in an increase in blood pressure sufficient for perfusion of tissues (including the heart), and thus for the resumption of contractile activity of the heart. Two heart rhythms are defined as a direct indication for defibrillation. These are: ventricular fibrillation and pulseless ventricular tachycardia. These are situations in which uncoordinated and accelerated work of the ventricles occurs. In the case of children, such disorders most often occur in the case of structural defects or chronic heart diseases that cause remodeling of the heart muscle itself. Therefore, remember the basic and important from this point of view the importance of cardiopulmonary resuscitation. Nevertheless, the European Resuscitation Council clearly points out the inseparable link between higher survival of victims and sudden cardiac arrest when the full set of rescue activities we discussed earlier is applied to only some of them. Early chest compressions, rescue breaths, and AED use as soon as possible increase survival between 50 and 70 percent.
  • Remember that if you are forced to use your rescue knowledge in practice, it will most likely be a great stress for you. But what exactly is this stress? In medical terminology, stress is a homeostasis disorder caused by a physical or psychological factor. Sounds great, right? How should this be understood? It is a condition in which the body's internal balance is disturbed. There can be many factors for this disorder, depending on the individual's predisposition to stress susceptibility. When stress occurs, the body tries to compensate for this condition with certain reactions aimed at responding correctly to changes in the external environment. So stress itself is not colloquially a bad thing. There are 3 types of reactions to stressors. We distinguish: neustress - i.e. a situation in which a given stimulus is indifferent to an individual, eustress - i.e. a situation in which stress pushes us and mobilizes us to act. It is the most positive form of stress response. We also distinguish distress or reaction consisting in hindering or inability to achieve human goals and tasks. It is the kind of reaction that we commonly say that "stress paralyzes us". The question arises: How to make stress motivate us to act instead of narrowing our perception and limiting our actions. Statistics are clear: we only act adequately to the situation when the stimuli we are stimulated are not completely alien to us. In the case of completely new incentives, we begin to think and analyze the situation trying to find a solution. There is no room for this in an emergency. That is why our goal as lifeguards is to develop certain procedures and constantly follow them so that in the event of an emergency situation, stress strictly follow these previously learned procedures without leaving room for error or uncertainty. This is the path taken by most professionals working under stress in our country and in the world, dramatically increasing the effectiveness of their activities. First aiders are another group that should benefit from these experiences.
  • European Funds - Smart Growth
  • Republic of Poland
  • European Union - European Regional Development Fund
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