Our time, energy and resources as parents are dedicated to bringing up a healthy child who is free of life-threatening complications. On the children’s side, they tend to try anything which leads them to endangered situations. That is why you need to equip yourself with CPR (cardiopulmonary resuscitation) knowledge in the event of a toddler choking or is having some difficulty in breathing. Even after taking a toddler CPR class, you need a handy guideline to be with you in every step since it is always an emergency case.
That is why we came up with information to get you ready on how to do CPR on a toddler when the demand arises. Read it through to distinguish infant vs. toddler CPR (check an article on infant CPR) so that you can avoid common mistakes by mixing up the details.
The details below reveal the following:
- CPR definition
- What you need to consider before performing toddler CPR
- When do you need a toddler CPR?
- Causes and Symptoms
- Toddler Compression: Ventilation Ratio
- The quality of chest compression
- Performing toddler CPR and first aid
- When do you need to contact a physician?
- Prevention measures
- What choking entails
- What to do if a toddler is choking
Table of Contents
- CPR Definition
- What You Need To Consider Before Performing Toddler CPR
- When Do You Need A Toddler CPR?
- Causes and Symptoms
- Toddler Compression: Ventilation Ratio
- The Quality of Chest Compression
- Performing Toddler CPR and First Aid
- When Do You Need To Contact A Physician?
- Prevention Measures
- What Choking Entails
- What to Do If a Toddler Is Choking
- Wrapping Up
CPR is an acronym for cardiopulmonary resuscitation. It involves a lifesaving protocol that can be used on anyone who is not breathing or no heartbeat. Children need it when they suffocate, drown, choke or have an injury. The CPR procedure involves the following:
- Rescue breathing:Supplying oxygen to the toddler’s lungs
- Chest compressions:They help to keep the blood circulating
NB: If blood stops flowing in a child’s body, it could result in death if not permanent brain damage. It is therefore essential that you keep doing the CPR until you feel the heartbeat, breathing or the arrival of a medical specialist.
What You Need To Consider Before Performing Toddler CPR
Someone trained to perform a CPR with an accredited course is always the recommended choice. Also, revising the techniques is necessary since the newest changes involve more of compression than airway opening and rescue breathing which turns around what we already know.
All parents need to learn about infant vs toddler CPR if they are not aware or confused
about the difference. When dealing with an unconscious kid, time is of the essence. After the 4th minute of no breathing, permanent brain damage is bound to occur. Death follows between the 4th and 6th minute.
Finding an AED (automated external defibrillators) is now easy, and you should consider one at your home. These are the machines that provide shock needed to get the heartbeat back. They have paddles that you can place on the chest of the unconscious kid, and a computer is also involved in detecting the pulse and rate. A sudden shock is given only when there is a guarantee that it will bring the heart back to the usual rate. Whether you know how to use it or not, always check the instructions when you are free to avoid any uncertainties.
When Do You Need A Toddler CPR?
Whether it is a layman or physician finding out that there are no life signs, CPR should commence immediately. Feeling the pulse is not the most reliable method to determine if the circulation is adequate or not. That means a child’s pulse palpation should not define the call for chest compressions. Other life signs like natural breathing, response or spontaneous movement must also be considered as you assess the circulatory progression.
If the child is unresponsive, the healthcare provider must ascertain that there is the presence of a pulse to disqualify the need to start a CPR procedure. Such a situation should also imply that there are other signs of life. A layperson should not be taught during the incidence on how to detect a pulse in determining whether a CPR is necessary or not.
Deciding whether to perform a CPR or not should be done within 10 seconds from the time of initial assessment. If there are still doubts after the check, start the CPR.
Causes and Symptoms
Children engage in many things so the reason for a heartbeat or breathing stop may be from either of the following occurrences:
- Bleeding excessively
- Electrical shock
- Lung complications
- Serious injury
The following symptoms should lead to a CPR:
- No pulse detected
- No breathing
The toddler is unconscious
Toddler Compression: Ventilation Ratio
This refers to how many compressions and ventilation are needed when doing the CPR on toddlers. Despite it being an essential aspect, rescuers who have no idea of what to do are encouraged to perform CPR with compressions only. Common sense, on the other hand, supports such advice since the child’s life is in danger and doing nothing is much worse.
Anyone within rescue is required to start the CPR on the kid even though they have not attended any pediatric CPR classes. The C: V ratio to give at this point is 30:2 which is familiar for most of us conversant with this subject. If you already know about the adult CPR, knowing about the various pediatric adjustments is vital in case you land on a child needing resuscitation.
For the children, the ratio cuts down to 15:2, which is the intended number for anyone more than one-year-old and less than 8-12 years of age.
The Quality of Chest Compression
Chest compression should be of high quality and uninterrupted. More attention is needed to the various compression components which include the depth, rate and time allowed for recoiling of the chest. The experts project that the relaxing phase should be approximately half of the whole compression cycle.
Development of devices that can train and bring feedback is in progress, but they require more of absolute than relative depth dimensions. For an adequate measurement for the children, the appropriate size for a third of the depth compressions in toddlers is about 5cm which a centimeter less for the infants.
For the best results, chest compressions should be done on a sturdy surface to get a better measure of the depth achieved.
Performing Toddler CPR and First Aid
Now that you know what a CPR and other vital details needed to determine its essence is, let us now look at how you can do a CPR on a toddler. Before you continue reading, here is a toddler CPR video that shows you the basics.
1. Check for consciousness
2. First, make sure that both you and the kid are in a safe place or location. Next, tap him or her gently and shout the name or something like “Are you okay?” as you continue checking, look for any injuries on the baby or if they are bleeding among other medical problems. All this should be done faster since there no delay chances at such a juncture.
3. See if there is any breathing
Move your ear near the kid’s nose and mouth. Do you hear any breathing? Are there breath deposits on your face? What about the chest movements, are they present?
4. Start performing chest compressions
If there is no response from the child, proceed to do the following:
- Make the child lie on his or her back by carefully moving them. If you are suspicious of a head or neck injury, roll the body by moving it all at once.
- Next, put one of your hand’s heel at the center of the child’s chest, preferably in line with the nipples. Here, you can use two hands to push, one under the other.
- Since we are focusing on a toddler, push down about 5cm or 2 inches. Do not insert pressure on the ribs since they are still fragile at the young age.
- Perform 30 compressions on the chest maintaining a rate of 100 in a minute. Allow the chest to rise as you push.
- Now, check if the child has resumed breathing.
5. If no breathing signs, keep doing the CPR until medical emergency arrives.
6. Perform rescue breathing
First, you need to do airway opening by lifting the kid’s chin upwards using one hand. As you do so, make the head to tilt backward by pushing the forehead down with the other free hand. If there is a head injury, don’t tilt it to prevent further complications. Now, cover his or her mouth with yours tightly. Close the nose by pinching and issue some breaths. You are supposed to give two breaths to the child and check if the chest is rising with breath given. Give a one-second duration before subjecting the second breath.
7. If there is still no sign of breath, do the rescue breathing and compressions again
8. At this point, give two breaths after every 30 compressions. If you have someone giving you a hand, perform 15 chest compressions followed by two breaths. Keep doing the 30:2 rate of compressions and breaths respectively until help arrives. If you are the only one around and have already done CPR for the last two minutes, which is about five compression cycles and breathing, proceed to call 911 before heading for an AED.
9. If there is an AED, get one as soon as possible
If your child or the one you are attending to is nine years old or younger, use the pediatric AED. If it is not available and the child is over one year, go for the standard one. Next, follow this procedure:
- Put the AED on.
- Dry the chest by wiping and place the pads.
- The AED has instructions on how to use it best, so it is advisable that you follow what the specifications say.
- Keep doing the compressions and follow the AED directions until emergency services arrive or the child has resumed normal breathing.
10. Placing the toddler in a recovery position
When the unconscious child has a clear airway and has returned to normal breathing, turn him or her to lie using the side which is known as the recovery position. There are some recovery positions, and each has its strong points. Some of the crucial doctrines to abide to include:
- Placing the toddler in a close to an absolute lateral position to allow for fluid drainage from his or her mouth.
- Making sure the child is stable while in that position. If required, place support on the back side. Could be a soft pillow or folded blankets.
- There should be nothing adding pressure on the chest to prevent breathing impairment.
- The child’s position should give room for comfortable and safe return on lying using the back considering that a spine injury can occur during the switch.
- The airway should be in an accessible position for easy checking.
- If you don’t know what to do at this point, but you are aware of the adult recovery position, use the method on the kid, and it will all be okay.
11. NB: Remember, Don’t
- Let his or her mouth to close. If you are aware or suspect the presence of a spinal injury, move the jaw in a forward motion by pulling and make sure the neck and head are still.
- Start performing chest compressions if the child is breathing normally, moving or coughing. You may halt the heartbeat.
Check the presence of a pulse. Only a trained person or a healthcare provider should do that.
When Do You Need To Contact A Physician?
If the child is still unconscious and there is no sign of breathing, then you need to get help immediately. Do either of the following depending on the nature of the situation:
If alone, shout for help and start the CPR procedure. If there is no progress after the
2nd minute and no one else has arrived so far, contact child emergency services or 911. We have our phones most of the time but if you do not have it with you, carry the kid to the next near phone. However, do not attempt to take the child if there is an injury.
If there is someone with you, one of you should call for an emergency while the other attends to the child and begin CPR.
The reason why you need to know about CPR, in general, is that your children might depend on it when solving a preventable misfortune. On the other hand, you can prevent multiple or few accidental cases by doing the following:
- Teach the children or how to stay safe with some basic principles to follow.
- If they are old enough, they can learn how to swim.
- Have them learn about road rules and watch for passing cars. This is especially useful when they are practicing on how to ride a bicycle.
- Follow the recommended guidelines when fastening the child’s car seat.
- If you possess a firearm, teach the kids about weaponry safety. Guns at home should be locked in a place out of children’s reach.
- Make sure they know what it means by ‘do not touch.’
You should always be concerned about your child’s health and safety status. Whether they
left alone to play or around you, keep a keen eye and don’t underestimate their ability to be at their worst any moment. Never forget the assumption that your child could to move from point A to anywhere and pick up more things than you could imagine.
What should be in your mind at all times is that your child might be up to something so be ready. Everyday activities include squirming and climbing. If the child is sitting in a high position – could be a stroller or chair, make sure they are safely strapped.
When choosing their toys, always go for those appropriate at their age. Fragile or more massive playing accessories are not suitable for them since the kids are known to experiment the unexpected. Before approving a toy, check if it has some sharp edges, loose parts or batteries among other vulnerabilities. Anything toxic which includes cleaning detergents should be stored away from their reach.
Always make sure that the children are staying or playing in a child-friendly environment. Provide supervision at all times especially when around tricky places such as around furniture or water. Electrical sockets, access to drugs or hot surfaces are hazardous to small children if left unmanned.
What Choking Entails
How to manage a choking toddler has remained the same since 2010, and the procedure for a complete obstruction or partial reversal is still intact and unchanged. Exercising chest and abdominal thrusts and back blows increase pressure on the thorax cavity, eventually expelling the foreign objects out of the airway.
Statistics show that half of the airway obstruction scenarios have utilized more than one method of relieving. There are no specific directions on which way to use first or the order of application. If one does not bring any success, try the rest as you rotate them until the object gets out.
The entrance of a foreign substance in the child’s trachea forces the toddler to cough immediately to remove it. It is much better for the kid to have an unprompted cough which proves to be safer and more effective than anything you might do. On the other hand, if he or she does not cough, then the object is almost wholly or entirely blocking the airway which leads to rapid deprivation of oxygen.
Therefore, we can conclude that the techniques used to eject the object should only be used only when a cough is not there. If they come in handy, you should be quick in what you are doing and be confident.
Most of the choking that happens in children occurs when they are eating or playing, and usually, a caretaker is present. Therefore, the witnessed events are countered with immediate interventions that are subjected to the child while still conscious.
Choking comes as a result of distress in the respiratory system which produces coughs, gaggles, and a whistling sound when breathing.
Choking due to intrusion by a foreign body should be determined if the following happens:
- The coughing was sudden
- No previous illness signs
- Clues are depicting the cause of choking to the rescuer.
General choking signs
- You witness the event
- Happened suddenly
Previous activity was playing while eating small objects
When is a cough ineffective?
- No vocals or difficulty to produce them
- A cough is silent
- Breathing inability
- Depreciating consciousness
- Cyanosis – skin discoloration due to low oxygen levels
When is a cough effective?
- More crying or the child is responding
- The coughs are loud
- The child can breathe before a cough
What to Do If a Toddler Is Choking
Bring them to safety and call for assistance
Use the safest means to solve the choking such as:
- If a cough is active, and that means the child is coughing out loud, you do not have to do anything. Let them cough and encourage them to do so, but keep your eyes on the toddler.
- If there is no coughing and the child is breathing heavily, call for help and monitor the child’s conscious level.
If the child is conscious and choking:
- If a cough is ineffective, perform some back blows.
- If there is no progress after the back blows, give the toddler some abdominal thrusts. This technique will make the child cough and increase pressure on the thorax cavity, which ejects the foreigner in the airway.
Back blows for a toddler
- Make the child lie in a head down position.
- If the toddler is still small, you can place him or her across your lap.
- Another option, if the above one is not okay, is to support the kid as they lean forward. Next, continue to give back blows.
- First, go behind the child and kneel which is a much better position than standing. Now, with your arms placed under the kid’s arms, enfold them to his or her torso.
- Grip your fist and place it between the umbilical and lower ribcage area.
- Hold his hand tightly with the free hand and pull abruptly in an inward and upward motion.
- Do it four times more.
- Ensure there is no pressure on the lower ribcage since you may cause the kid to have abdominal trauma.
- The primary objective here is to clear the obstruction after every thrust.
Checking for progress
- Is the object is not yet out, but the child is conscious, repeat the back blows and abdominal thrusts.
- Call for help if someone is not yet there.
- Stay with the child all through.
- After a successful expelling of the object, check the child with the help of a medical professional. What to look for is if any object parts are remaining in the air track.
If the child is unconscious after choking:
- When the child becomes unconscious, place him or her on a flat but firm surface.
- Call for help if no one is around.
Stay with the kid all through.
Opening the airway
- Open the child’s mouth and check if you see anything.
- If you spot something, try to pull it out using one finger, in a single sweep.
- Do not try multiple sweeps; it may cause injury or further sinking of the object.
Performing rescue breaths
- After opening the airway, try five rescue breaths
- Check for progress after each breath. If the chest does not rise, adjust the head’s position before trying the next breath.
CPR and chest compression
- Do five rescue breaths and if nothing happens, proceed with chest compressions and don’t wait to see if the breaths worked.
- Next, perform CPR of a single rescuer for about a minute before calling for assistance.
- After opening the airway for rescue breaths, check to see if you see an object. If present, sweep it out using one finger.
- If the obstruction is out, recheck the airway. Perform some rescue breaths and look for life signs. If it is all silent, progress to do CPR and chest compressions.
- When the child is finally conscious, and breathing is as usual, place him to lie on the side and keep monitoring them until medical help arrives.
Now, you are aware of what to do when your child involves themselves in a life-threatening accident. We hope that you may never use all of the above on your kid, but since they are discoverers, anything is bound to happen. So, keep watching and always be prepared.