How to perform CPR for an infant, child or teen with a tracheostomy

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Find step-by-step instructions on how to perform CPR on an infant, child or teen with a tracheostomy tube.

By the end of this chapter, you will be able to:

  • demonstrate what to do before performing CPR on an infant, child or teenager
  • demonstrate the steps to perform CPR

Important!

The instructions below are not intended to replace hands-on CPR training from your child’s health-care team.

The table below has instructions on performing CPR for an infant, child or teen with a tracheostomy. Familiarize yourself with these steps.

How to perform CPR when a child has a tracheostomy

TeenChildInfant
1. Secure the scene Make sure the immediate environment is safe.
2. Check person

Check breathing and pulse rate for responsiveness. Signs that a person is unresponsive include:

  • no breathing or only gasping
  • no response with touch
3. Call 911Call for help.
If alone, call 911 and put them on speakerphone.
If alone and without a phone, find one and call 911.
Call for help.
If alone, call 911 and put them on speakerphone.
If alone and without a phone, start CPR (see step 4) before trying to find a phone.
  • If you are alone without a cell phone and did not see the onset of the breathing emergency, do two minutes of CPR before getting help.
  • If someone is with you, have them call 911. Ask them to tell you when that is done.
  • Ensure you let the EMS dispatcher know that the child has a tracheostomy.
4. Start chest compressions
  • Start doing 30 chest compressions, followed by two breaths (see below).
  • Compress at a rate of 100-120 compressions a minute.
  • Ensure that the chest recoils (goes back to its original position) after each compression.
  • If there is another person with you, take turns following the 30:2 ratio of compressions to breaths. Once you perform two minutes of CPR (chest compressions and breaths), have the second person perform CPR for two minutes.
  • Continue switching roles every two minutes or switch sooner if one of you is too tired to continue chest compressions.
For children and teenagers:
Place the heel of one or two hands over the lower third of your child's breastbone. Be sure to push hard enough so their chest moves approximately 5 cm (2 inches) down (push hard). Ensure you allow the chest to rise all the way back up each time.
For infants (less than one year of age):
Place your two fingers on the breastbone, just below the nipple line. Be sure to push hard enough so their chest moves approximately 4 cm (1.5 inches) down (push hard). Ensure that you allow the chest to rise all the way back up each time
5. Give breaths
  • Uncover the tracheostomy tube so the manual resuscitation bag can be attached.
  • Use the manual resuscitation bag to give two breaths into the tracheostomy tube as you were taught. Give just enough air volume to make the chest rise.
    • If the chest does not rise with a manual breath, suction before trying two breaths again.
    • If there is no chest rise, change the tracheostomy tube before trying two breaths again.
    • If you cannot replace the tracheostomy tube, give ventilation through the mouth and nose, as with regular CPR or through the stoma if your child has a critical airway
6. Continue CPR
  • Give CPR in 30:2 ratio (alternating 30 compressions and two breaths).
  • Continue until medics arrive with an AED (automated external defibrillator).
  • If you are in a public place with an AED, ask someone to bring it to you.
  • Keep CPR going for two minutes. This is five cycles of 30:2 (30 compressions and two breaths).
  • Stop CPR after two minutes to call 911, if not already called.
  • Resume CPR until medics arrive.
7. When to stop CPR
  • Stop chest compressions when you see signs of life.
  • Continue to support breaths with manual resuscitation bag if needed.
Dernières mises à jour: novembre 10th 2023