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What we are going to look at now is Infant CPR for healthcare professionals. And there are two guidelines. There is one for first aiders and one for healthcare professionals with the duty to respond in an emergency. The main difference is just the number of compressions. If it is a first aid environment, we are going to be delivering five breaths, we give 30 compressions, two breaths, 30:2, 30:2. And with the healthcare professional version, we deliver in five breaths and then 15 compressions, 2:15, 2:15. So, that is the key difference. Remember, with an infant, within with a not to one-year-old and we will go through exactly the same procedures within consent and also safety, making sure we are wearing gloves.

And as far as which version you want to use, generally speaking, you would use the healthcare professional version. But, if in your professional opinion that 30 and 2 would be a better option, then you can use either option. As far as delivering the breaths, we are gonna demonstrate doing mouth-to-mouth or mouth-to-mouth-to-nose on this mannequin. But you can also use pocket masks remembering that pocket mask would go up the other way or on to an infant. Or you can use your BVM and obviously you are using an infant version and you can pop that straight and deliver the breaths that way.

In this example, rather than using the BVM, we are going to deliver the breaths directly into the mouth and the nose. In this scenario, we have consent and we have our BVM on and our gloves on. The first thing we gonna do is check to see whether we get a response from the infant. So, we can tap its foot, we can tap its shoulder, we can talk to it, ask it a direct question, "Are you okay?" just to try and get a response from the infant. If we do get a response, whether noise, movements, or eye twitching, then obviously we are not gonna be doing CPR.

In this example, we have no response whatsoever, so we need to open the airway. Remembering when you are opening the airway, the infant is in a neutral position. So its head tilt, chin lift, the same, fingers on the top on to the base of the chin, the bony part of the chin. We just tilt it back into a neutral position. Do not overextend this way because, just like a garden hose, when you twist it, you are gonna block off the airway because it's not fully developed.

So we literally open the airway to a neutral position. Pop your air down and we look, listening and feeling the signs of breathing for 10 seconds. One, two, three, four, five, six, seven, eight, nine, ten. At that point, we've assessed the time that there's no breathing. We have felt for breathing on our cheek, we have looked down the chest as we are doing it. We would make sure we have activated assistance, calling for help. If you are out on your own, then there's a set rule. If you are on your own dealing with an infant on CPR, you would call emergency services after one minute because this is likely to be a respiratory problem rather than a cardiac problem. So, by delivering CPR for a minute, there is a chance you could bring this infant back.

But, basically, even this example here, we are assuming that help is on its way and help is coming. Well, first thing we need to do is deliver five breaths. So we are sealing our mouth around the mouth and the nose, we deliver in five breaths in, they are just short puffs. We do not want to put too much in because it will overinflate and the air could then move into the stomach. We just want to give a little puff until we see the chest rise. And we are delivering five initial breaths.

Once we delivered the five breaths, we then want to deliver chest compressions and we are delivering the chest compressions around about third the depth of the chest. And we are delivering them at a rate of 100-120 compressions per minute, which is roughly two a second. Just using two fingers and we can pop those two fingers on the centre of the chest and we are delivering 15 compressions.

Once you are done with 15 compressions, back, open the airway into a neutral position, deliver two breaths.

And then we go straight back to compressions and we deliver another 15 compressions. Now, delivering that cycle there, if you are in a hospital setting, help is going to be on its way and lots of other people will be around, but this is the initial basic life support for dealing with an infant by a healthcare professional. Finally, there is another method of delivering the compressions which can be determined from around to the side and deliver the compressions with your thumbs.

It's not used in first aid, it's more of a healthcare professional side. It also means that you can keep yourself away from the head end where somebody else could be delivering the breaths. But, generally speaking, if you are on your own using two fingers is actually quite an the easy, simple way of delivering those compressions.