At the end of this chapter, you will be able to:
- understand the importance of learning CPR and updating skills annually
- understand how to perform CPR for your infant, child or teen who has a tracheostomy
What is CPR and why is it important?
Cardiopulmonary resuscitation (CPR) is a life-saving procedure that combines chest compressions and breaths on a child or infant who is having, or is about to have, a cardiac arrest (heart attack). CPR should be done for any child or infant who is unresponsive with abnormal breathing or no breathing at all. All caregivers must have CPR training and renew their certification annually.
CPR is vital because it tries to:
- preserve brain function
- restore blood circulation
- restore breathing
What are the components of CPR?
CPR consists of compressions and breaths. The general guideline for chest compressions is 30 compressions, at a rate of 100 to 120 compressions a minute, followed by two breaths. This is known as a compression-to-breath ratio of 30:2. One ratio is equal to one set.
Please see the page "How to perform CPR for an infant, child or teen with a tracheostomy" for more information on how to do this for a child with a tracheostomy.
What are the common causes of abnormal breathing?
In most cases, a child's heart stops beating not because of a problem with their heart (unless they have a primary heart condition) but because of a breathing emergency. A breathing emergency can occur if:
- there is not enough oxygen in the air your child is breathing in
- your child's heart and lungs are not working properly
- your child's airway is blocked because of an
- airway obstruction (for example, choking or a blocked tracheostomy tube)
- allergic reaction
- upper respiratory tract infection.
What can I do to prevent breathing emergencies in my child?
To prevent breathing emergencies:
- make sure your child has enough humidity
- suction the tracheostomy tube appropriately to prevent it from plugging
- make sure your child is cared for by an alert caregiver who is trained in tracheostomy management and care
- make sure that your child is not pulling out their tracheostomy tube
- make sure your child is not putting anything into their tracheostomy tube
- supervise your child when they are with small children who may pull at the tracheostomy tube or put something in it
- monitor your child’s blood oxygen level with an oximeter
- contact your child's health-care provider if you observe early signs of infection in your child (early recognition of illness is very important)
How will I know that my child has stopped breathing or has ineffective breathing?
Your child’s breathing has stopped when:
- their chest does not rise and fall
- you cannot hear or feel air movement
Your child’s breathing is ineffective when:
- they have very slow and shallow breaths
- they have very fast and shallow breaths
- their breathing is laboured and noisy, as if gasping for air
- they are experiencing fatigue
- their skin is sweaty (this may mean they are having difficulty breathing)
- their skin colour is slightly blue
- they are less alert, aware and responsive than usual
If your child stops breathing or has ineffective breathing, their body does not get enough oxygen. You must act immediately to restore or improve their breathing.