“Help! My baby is not breathing!”

“Help! My baby is not breathing!”

Your first instinct is to immediately respond, recognising the emergency! Very often, people panic! “I don’t know what to do”or “I’m not a doctor” should not and need not be the case. In such an emergency, immediate action is your job, it would be too late to wait for a doctor. In conjunction with World Heart Day, I would like to discuss on life saving Cardiopulmonary Resuscitation (CPR) procedures on infants.

In hospital’s Paediatric Department, before discharging a newly born baby who was on prolonged oxygen therapy, cardiovascular patients, or other patients that have risks of needing CPR, the practice is “to teach parents or caregiver CPR”. We would teach and provide pamphlets on how to perform CPR in case of an emergency. I strongly believe everyone should be taught this life saving technique.

Indications

The indications to start CPR on infants are:

1. Unconscious
2. Unresponsive
3. Not breathing

You will first need to ensure that the environment is safe for you and the baby. Call for help from anyone at the scene to call for an ambulance. If you’re on your own, use a mobile speakerphone, so you can perform CPR as soon as possible. If you’re on your own and don’t have a mobile speakerphone, you will need to do CPR for a minute before you call for help.

In any medical emergency, make sure you follow ABC steps. These steps include:

Airway

Gently place one hand on the forehead and the other hand gently lifting the chin causing the head to tilt in order to open the airway. Pick out any visible obstructions from the mouth and nose. Then examine the breathing effort of the baby by:

• Looking – at the chest and abdomen movement
• Listening – to the baby’s breathing
• Feeling – the aspiration of the baby’s breath

Breathing

If there’s breathing, turn the baby to its left side. This is called the recovery position. Continue to monitor the baby’s breathing until help arrives.

If there’s no breathing, give 5 rescue breaths or ‘puffs’. A rescue breath or ‘puff’ is to:

1. Take a breath
2. Put your lips around the baby’s mouth and nose to make a seal
3. Blow gently steadily for up to one second

The chest should rise. Remove your mouth and watch the chest rise. Do this step for 5 times.

Circulation

Check the following signs:

1. Movement of the baby
2. Cough
3. Normal breathing
4. Pulse

If none of the signs are present, start chest compression.

1. Lay the baby on a hard surface
2. Use two-three fingers in the centre of the baby’s chest and below the nipple level
3. Push down a third of the depth of the chest or 4cm deep
4. Hand-encircling or two-finger technique
5. Release the pressure, allowing the chest to come back up before pressing back down again
6. Repeat this at a rate of 100-120 pumps per minute
7. After 20-30 pumps, give 2 puffs
8. Your fingers should be on the baby’s chest at all time
9. Repeat until ambulance has arrive or baby is showing one of the 4 signs mentioned above
10. If baby is showing any signs of life, to put baby in the ‘recovery position’

Continue these steps till the ambulance has arrived.

How To Perform CPR on a Baby with Dr. Jim Sears Video:

https://www.youtube.com/watch?v=YeI7uiD8TZU

Take home message

CPR is not only a medical personnel’s role, it’s a vital role to be performed by everyone especially parents. An emergency could happen to anyone’s child, even yours. When it does, it is always sudden and panic will take over, however, if you already know what to expect, you should remain calm and follow these steps.

I reviewed a 6 months old baby recently who has broncho-pulmonary disease. After 3 months being in the neonatal ward, the baby was discharged. However when the baby was 5 months old, the baby fitted for 10 minutes. The mother commenced CPR till the ambulance arrived. The baby was, subsequently, intubated at the hospital for respiratory distress. After 1 month at the hospital, she’s now going to be discharge soon.

If the mother hadn’t known CPR, the baby would have had the possibility of dying on the way to the hospital. COMMENCING CPR WITHIN FOUR MINUTES IMPROVES THE CHANCE OF SURVIVAL. Learn CPR, don’t let an innocent soul die due to your ignorance.

If you would like to make an appointment with an pediatrician:

Find a pediatrician in Malaysia, on GetDoc

Find an pediatrician in Singapore, on GetDoc

Reference

https://www.youtube.com/watch?v=avYRvVHAvfM

CPR Pamphlet (<1 years old) of Hospital Sultanah Aminah, Johor Bahru

http://raisingchildren.net.au/articles/pip_cpr_babies.html

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