Why is it important to know CPR for children?

A sound knowledge of Cardio Pulmonary Resuscitation (CPR) is important for any carer. However, there are many people who don’t see the importance of this knowledge for a nanny. In reality one to two children in every hundred thousand suffer a sudden cardiac arrest each year. A significant number more experience cardiac arrest due to congenital heart disease, with a proportion of these cases being undiagnosed before the incident.
While it is hoped that all children are healthy and that such tragedy won’t befall them, it is imperative that your nanny has a sound understanding of CPR and is capable of performing it in an emergency. The immediacy of their response can literally be the difference between life and death and their ability to perform it properly on a child is vital.
Although it may be stating the obvious, children and infants are significantly smaller than adults. The development of their chest and windpipe at the time of an incident can have a profound bearing on the way CPR is administered.
In the initial moments of realizing that a child has stopped breathing, the carer needs to give two quick breaths in about two seconds. However, great care is required to avoid damaging the lungs of the child. While providing the breaths to a child over the age of one year, the carer must be aware of the rise of the chest of the child; a clear rise of the chest is essential, but too much force can have devastating results. In the same way, when providing two quick breaths for an infant, younger than one year of age, the breath should be no more than a puff that fills the carer’s cheeks.
In order to administer the breaths effectively, the carer needs to be sure that the airways are clear and, for a child older than one, a slight head tilt is required. This is similar to the needs of an adult and the purpose is similar in that the breath needs to progress to the lungs and not simply inflate the stomach. As for an adult, the mouth of the carer needs to seal around the mouth of the patient and the nose should be pinched to stop the breath only circulating through the upper respiratory tract.
When dealing with a child under the age of one, the head is not tilted. Due to the flexibility of the still developing trachea, the windpipe will close if the head is tilted. An infant in such a dilemma can be cradled in the crook of the carer’s elbow with the head supported by the hand of the carer and lifted to the carer’s mouth as required. Given the size of the mouth and nose of the infant, it is often easier to form a seal entirely over the mouth and nose of the child with the mouth of the carer.
Should the child’s heart also have stopped, then compressions of the chest will be required. The location of the compression site is similar for a child over the age of one as it is for an adult, but the compressions must be no more than one third the depth of the chest. On most children this will mean a compression of between one and one and a half inches (two to three centimeters).
The same proportion of depth on a baby under one year is required, that is, one third the depth of the chest, which equates to a half to three quarters of an inch (one to one and half centimeters). However, rather than locating the compression site specifically, compressions should be made with two fingers only to the lower half of the sternum.
While the focus of any such situation must be on the patient, it is important that your nanny be aware of the dangers of exchanging bodily fluids. For this reason, your nanny will hopefully have a professional breathing mask in her equipment bag or at least a specially designed plastic shield to create a barrier between the child and the nanny’s mouth.
The difference between administering CPR to an adult, a child and an infant are largely obvious in the calm light of a discussion, but it is imperative that your nanny is practiced and confident in providing this life saving skill on a child or infant in an emergency situation.