Care of Mother and Child At-Risk orwith

Problems (Acute and Chronic)-RLEModule

#21 Student Activity Sheet

Nam Class

Section: Dat

Lesson Title: Cardiopulmonary Resuscitation for Materials:

Newborns and Infants SAS, OB book, pens

Learning Targets: References:

At the end of the module, students will be able to:
1. Integrate the knowledge of the new guidelines in giving 2020 AHA Guidelines Update for CPR
quality child health nursing care.
2. Apply the knowledge of the new guidelines in giving
quality child health nursing care.

CPR in Infant

How to use Automated External

Defibrillator

A. LESSON REVIEW/PREVIEW

B. MAIN LESSON

CARDIOPULMONARY RESUSCITATION FOR INFANTS

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 Care of Mother and Child At-Risk orwith
Problems (Acute and Chronic)-RLEModule
#21 Student Activity Sheet

Nam Class

Section: Dat

CPR: for infants 0-1 in age

CABD (Circulation, Airway, Breathing, Defibrillate)
An infant is found lying on the ground.

Assess to make sure the scene is safe for you to respond to the down patient.

Assess Unresponsiveness:
 Lightly shake or tap the infant’s foot and say their name.
 Look at the chest and torso for movement and normal breathing.

If the infant is unresponsive:

 (One provider) If alone and collapse is un-witnessed: First perform 2 minutes of CPR then call the
emergency response team and bring an AED to the patient.
 (One provider) If alone and collapse is witnessed: First call the emergency response team and bring
an AED, then start CPR.
 (Two providers) Have someone near call the emergency response team and bring the AED and you
start CPR.
 Place patient supine on a hard flat surface.
Circulation
Feel for either the brachial or femoral pulse (Do not check for more than 10 seconds).

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 Care of Mother and Child At-Risk orwith
Problems (Acute and Chronic)-RLEModule
#21 Student Activity Sheet

Nam Class

Section: Dat

brachial and femoral pulse

If the infant has a pulse:

 Move to the airway and rescue breathing portion of the algorithm.
 Give 12-20 breaths per minute.
 Recheck the pulse every 2 minutes.

If the infant doesn’t have a pulse:

 Begin 5 cycles of CPR (lasts approximately 2 minutes).

Start with Chest Compressions:

 Provide 100 to 120 compressions per

minute. This is 30 compressions
every 15 to 18 seconds.
 (One provider) Place two fingers on
the sternum of the lower chest. One
between the nipple line and the other
1cm below.
 (Two providers) Encircle the infant’s
torso with both hands with both
thumbs pointing cephalic positioned
1cm below the nipples over the
sternum.
 Chest Compressions should be at
least 1.5 inches or 1/3 the depth of infant’s chest.
 Press hard and fast.

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 Care of Mother and Child At-Risk orwith
Problems (Acute and Chronic)-RLEModule
#21 Student Activity Sheet

Nam Class

Section: Dat

 Allow for full chest recoil.

 Only allow minimal interruptions to the chest compressions.
 (One Provider: 1 cycle is 30 chest
compressions to 2 rescue breaths)
(Two Providers: 1 cycle is 15 chest
compressions to 2 rescue breaths)

If you have two providers: switch rolls

between compressor and rescue breather
every 2 minutes or 5 cycles of CPR.

Airway
In the event of an unwitnessed collapse, drowning, or trauma:

Use the Jaw-Thrust maneuver. (This maneuver is used when cervical spine injury cannot be ruled out.):

 Place your thumbs on the upper cheek bones of the infant.

 Place your fingers on the lower rami of the jaw.
 Provide anterior pressure to advance the jaw forward.
In the event of a witnessed collapse and there’s no reason to assume C-spine injury:

Use the Head Tilt-Chin Lift maneuver:

 place your palm on the patient’s forehead and apply pressure to tilt the head backward.
 place the fingers of your other hand under the mental protuberance of the chin and pull the chin
forward and cephalic.

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 Care of Mother and Child At-Risk orwith
Problems (Acute and Chronic)-RLEModule
#21 Student Activity Sheet

Nam Class

Section: Dat

Breathing
Scan the patient’s chest and torso for possible movement during the “assess unresponsiveness” portion of
the algorithm. Watch for abnormal breathing or gasping.

If the infant has adequate breathing:

 Continue to assess and maintain a patent airway and place the infant in the infant recovery position.
(Only use the recovery position if its unlikely to worsen patient injury)
If the infant is not breathing or is inadequately breathing:

If the infant has a pulse:

commence rescue breaths immediately.

 If the infant doesn’t have a pulse:

begin CPR (go to Circulation portion of the algorithm).

 Use a barrier device if available.
 Make a seal using your mouth over the mouth and nose of the
patient.
 Each rescue breath should be small and last approximately 1
second.
 Watch for chest rise.
 Allow time for the air to expel from the patient.

During normal CPR with an advanced airway:

 Provide 12-20 rescue breaths per minute (do not stop chest
compressions for rescue breaths).

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 Care of Mother and Child At-Risk orwith
Problems (Acute and Chronic)-RLEModule
#21 Student Activity Sheet

Nam Class

Section: Dat

 If the patient has a pulse and no CPR is required:

Provide 12-20 rescue breaths per minute.

 Recheck pulse every 2 minutes.

Recovery position for infants

 Cradle the infant with the infant’s head tilted downward and slightly to the side to avoid choking or
aspiration.
 Continually check the infants breathing, pulse, and temperature.
Defibrillate
Arrival of AED (Automated External Defibrillator)

Power:
 Turn AED On NOW! (early defibrillation is the single most important therapy for survival of cardiac
arrest. Begin use on patient as soon as it arrives).
 Follow verbal AED prompts.

Attachment:
 Firmly place appropriate pads (adult/pediatric) to patient’s skin to the indicated locations (pad image).
Analyze:
 A short pause in CPR is required to allow the AED to analyze the rhythm.
 If the rhythm is not shockable:

Initiate 5 cycles of CPR.

 Recheck the rhythm at the end of the 5 cycles of CPR.

If shock is indicated:
 Assure no one is touching the patient or in mutual contact of a good conductor of electricity by yelling
“Clear, I’m Clear, you’re Clear!” prior to delivering a shock.
 Press the shock button when the providers are clear of the patient.
 Resume 5 cycles of CPR.
 Manual defibrillators are preferred for infant use. If the manuals defibrillator is not available the next
best option is an AED with a pediatric attenuator. An AED without a pediatric attenuator can also be
used.
ADVANCE CARDIAC LIFE SUPPORT
 Advanced airway interventions, such as supraglottic airway (SGA) placement or endotracheal
intubation (ETI), may improve ventilation, reduce the risk of aspiration, and enable uninterrupted
compression delivery.

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 Care of Mother and Child At-Risk orwith
Problems (Acute and Chronic)-RLEModule
#21 Student Activity Sheet

Nam Class

Section: Dat

 Airway placement may interrupt the delivery of compressions or result in a malpositioned device.
 Advanced airway placement requires specialized equipment and skilled providers, and it may be
difficult for professionals who do not routinely intubate children.

Check for Understanding

You will answer these questions below and it will be recorded as your quiz.

1. A 7-month-old appears to be conscious and not breathing. You check for a pulse at the:
A. Brachial
B. Femoral
C. Carotid
D. Coronary

2. A machine that converts ventricular fibrillation into a perfuming rhythm and that allows for early
defibrillation by first responders:
A. Allis Clamp
B. Advance Cardiac Life Support Machine
C. Ambulance
D. Automated External Defibrillator

3. The emergency medical service has transported an 8th-month-old and is being transferred to the
emergency stretcher, you note unresponsiveness, cessation of breathing, and unpalpable pulse.
Which of the following task is appropriate to delegate to the nursing assistant?
A. Assisting with the intubation
B. Placing the defibrillator pads
C. Doing chest compressions
D. Initiating bag valve mask ventilation

4. Before responding to a first aid scenario, what is the first question you should ask at the scene?*
B. A. Age of the injured or ill person
C. Safety of the scene
D. Nature of the injury
E. Time of the injury

5. You are first to the scene and you find an unresponsive baby with no pulse that has thrown up. You
feel CPR is not something you are comfortable giving them. What would be the next best thing for you
to do?
A. Wipe off the face or cover with a shirt
B. Compression only CPR
C. Go and get help

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 Care of Mother and Child At-Risk orwith
Problems (Acute and Chronic)-RLEModule
#21 Student Activity Sheet

Nam Class

Section: Dat

D. Do not initiate resuscitation

6. What would your next step be after you are performing single-person CPR and the AED (Automatic
External Defibrillator) advises a shock?
A. Call for help
B. Resume CPR with chest compressions
C. Check for a pulse
D. Resume ventilation

7. One of your 2-month-old infant isn't feeling well and lays down for a nap. After checking on the baby,
you notice they are not breathing and are blue in color. What would be the best step to take?
A. Do back blows.
B. Do a blind finger sweep.
C. Call 911.
D. Deliver two minutes of CPR.

8. What do you do if an infant is choking and while trying to assist them they become unresponsive?
A. Leave the infant to get help.
B. Do a blind finger sweep.
C. Begin CPR.
D. Do abdominal thrusts.

9. Properly operating an AED include the following steps:

A. Power on the AED, attach electrode pads, shock the person, and analyze the rhythm
B. Power on the AED, attach electrode pads, analyze the rhythm, and shock the person
C. Go and gePower on the AED, analyze the rhythm, attach electrode pads, and shock the person
D. Power on the AED, shock the person, attach electrode pads, and analyze the rhythm

10. While performing CPR on an infant, another rescuer appears on the scene, what do you do next?
A. Immediately transport the patient
B. Wait until exhausted, then switch
C. Have the second rescuer help with CPR, to minimize fatigue
D. Have the second rescuer begin ventilations; ratio 30:2

C. LESSON WRAP-UP
AL Strategy: Minute Paper
1. Please prepare a question or write a question in an index cards or half-sheets of paper to write
feedback to the following questions:

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 Care of Mother and Child At-Risk orwith
Problems (Acute and Chronic)-RLEModule
#21 Student Activity Sheet

Nam Class

Section: Dat

a. What was the most useful or the most meaningful thing you have learned this session?
b. What question(s) do you have as we end this session?

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