Note: These training videos are the same videos you will experience when you take the full Paediatric 1 day First Aid for Nannies and Au Pairs program. Your progress in watching these videos WILL NOT be tracked. You may begin the Paediatric 1 day First Aid for Nannies and Au Pairs training at any time to start officially tracking your progress toward certification.
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No one can prepare you really for having to do CPR on an infant. Remember, with an infant, we're talking about from the age of birth to one year old. If you had to do this for real, you really are going to need to trust your training. You would need to do it, and I'm not saying it's not going to be upsetting, but it is necessary. Now, if an infant is unresponsive, the first thing we're going to need to do obviously is to do a correct safe approach. And also, we may very well need to ask a parent or a guardian or whoever is looking after the child. And then we need to get some response out of the child. Now, to do this, the normal way, the introducing yourself, obviously, an infant like this wouldn't be responding, so we need to do other ways of trying to stimulate the child. We can do things like just tapping on to the foot to try and get a response, talking to the child, giving them a little tap just trying to get some response out of it.
If we get no response, then we need to find out if the child is breathing. To do this, we need to open the airway but not in the same way as we would do with an adult or a child. If we were to tilt the head right the way back, because with an infant, the windpipe, the trachea is not actually fully developed, so if you tilt the head too far back in some cases, this can block the airway. Very much like if you've got a garden hose, if you take the garden hose and you just bend it too much, what will happen is it will cut the flow of the water coming out. This will work the same thing with an infant. What we need to do is just to move the head into a neutral position rather than fully overextend it. We're still using the hand on the forehead and on the bony part of the chin. We can have a quick look inside the mouth to make sure that there's nothing in there, and then we're going to do a breathing check for 10 seconds.
For this, we look, listen, and feeling for signs of normal breathing. Pop your ear down, look down the body, and then count one, two, three, four, five, six. At this stage, we've found out that the baby is not actually breathing. If it was breathing, then we would need to bring it into your arms and hold it into what would be the recovery position, onto its side and then nurture it. And also, make sure we get it to the emergency services and get some help if there's a problem. If the infant is not breathing, obviously, we're going to need to do CPR. We would have already shouted for help. We would make sure that help is on its way. In most instances, we'd also be wearing gloves. However, in this example here, if I've just come into a room and found an infant, how am I going to go away and get gloves and delay this? Because it's crucial that we carry this procedure on. So, wearing gloves, yes, it is very, very important. But fully appreciate there are times in a first aid emergency like this that you're not going to have the gloves on.
The first thing we need to do is deliver five rescue breaths. To try and squeeze the nose and blow into the mouth like we would with an adult or a child is very, very difficult. What we need to do is seal our mouth around the mouth and the nose. We're moving the head into a neutral position, we're delivering five breaths, and these are just quick breaths just so we see the chest rise. And so, we're just delivering those. Don't overextend it. Don't put too much in because this infant does not need the sort of volume that's inside your lungs.
Once we've delivered those five breaths, we then need to do compressions. The idea of the compressions is to push down on the chest, so we're forcing the heart and all the blood in the heart out and then when we let go, the chest will release and the blood will be sucked back in. We need to push down at least one third the depth of the chest. And we're doing this at a rate of 100 to 120 compressions per minute making sure that the downward stroke and the upward stroke are the same time to allow the heart to fully fill up with blood again.
Adult, we're using two hands, child, one hand, and infant, we're just using two fingers. And we're using these two fingers just in the centre of the chest. The reason why we're using two fingers is we don't want to be down on the chest. If we used a whole hand on there, what we're going to end up doing is pushing the entire ribcage down although we only wanted to put the pressure right where the heart is. Taking the two fingers into the centre of the chest, and we're pushing down one-third depth and 30 compressions.
Once we've done those 30 compressions, then we're going to reopen the airway. Remember, don't overextend it. Give two breaths and then back to 30 compressions. Open the airway, compressions, so two breaths, 30. Just to recap on that, we're giving five initial breaths, then 30 compressions, two breaths, 30, 2, 30, two, 30, 2.
Now, as far as the emergency service is concerned, then if we are dealing with an infant, what we need to do is we need to make sure the emergency call service has been called straight away. If there are people around, get them to call the emergency services and get them to come back and tell you what's happened. If you were on your own, the guidelines are you'll do one minute of CPR and then go and for help. But you could take the infant with you, you can carry the infant. You could even do compressions while on the move. The important thing is we do call the emergency services. If we do the CPR for a minute, there is this chance that the action of breathing and compressions will start the infant breathing again.
You may find doing these compressions tiring so it may be that you could hand over to another person there and maybe the parents if they can help, or maybe another childminder. And also think about where the emergency services are coming, so you can maybe move the infant over there. But you are doing this on... Here, we've got it onto a table top. You could do it on the floor, and if it is an extreme circumstance, you can do it on your arm but just think about the weight of a baby. To be able to do compressions effectively on your arm, it's not very good. However, moving the baby from here, and throughout the door, into the car park to meet the emergency services, well yeah, you could be doing compressions at that time to get the child to the emergency services as quickly as possible.