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Fundamental Differences Between Adult and Infant CPR

WakeMed Heart Center trained more than 500 members of the community in compression only CPR during the month of February.  At these events, we were consistently asked to offer classes on infant in the community, and as a result are currently in the planning process to offer these classes. In the meantime, we thought it would be helpful to explain the differences in infant and adult CPR, so we asked Dr. Amy Griffin, medical director of the Children’s Emergency Department, to share information about infant CPR.  Here is her contribution:

There are fundamental differences between when adults and infants or children need CPR.  Adults usually have a cardiac arrest because of a heart attack.  If a child requires CPR, it is more likely as a result of a respiratory issue that then leads to a cardiac arrest.  For an adult suffering cardiac arrest, their best and often only hope is to be shocked by an AED.  For a child, they are most in need of oxygen.

With infants, especially babies that are teething and frequently putting things in their mouth, airway obstruction is a real danger.  A penny or peanut found on the floor can cause the baby to choke, have respiratory arrest, and as a result go into cardiac arrest.

This is a parent’s worst nightmare, and unfortunately it can and does happen.  This is why it is critical that all parents and caregivers know how to react in the event a child has cardiac or respiratory arrest.  Knowing what to do can literally be the difference between life and death.

If this happens, open your child’s mouth and remove the item if you can.  And contrary to previous recommendations, caregivers should NOT blindly do a finger sweep because there is a chance that if there is something in the airway that they can actually push the item further down.

If you find an infant less than 1 year old that is unresponsive:

  1. Tap on their heel or on their chest – something that irritates them enough so they wake up.
  2. If they do not respond and are not breathing (or only taking gasps), then check for a pulse.  If no pulse can be identified, then start chest compressions. It is often difficult to identify a pulse, so if in doubt, start compressions.
  3. Chest compressions should be done with two fingers at the level of the nipple.  The rate should be 100/minute.  After 30 compressions, stop to give two breaths. The depth of compressions should be  1.5 – 2inches.
  4. When giving breaths to an infant, you should cover their nose and mouth with your mouth. (If you are giving breaths to a child, you should just cover their mouth with your mouth and pinch their nose.)
  5. Continue giving compressions and breaths at a ratio of 30:2 until help arrives.
  6. If you are alone, you should provide 2 minutes of CPR prior to calling for help.

Put CPR on the list of things to learn because it could save your baby’s life, make sure your babysitter has CPR certification, and remember for infants and children, think respiratory first.

The American Heart Association has an infant specific CPR Anytime for Friends & Family.  Purchase one by clicking here.

WakeMed Children’s is dedicated to providing answers to common questions parents have about children’s health and wellbeing.   Learn more by subscribing to WakeMed’s Families First newsletter.  Have a specific question you would like answered?  Post a comment or email us directly.


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