4. Size of Victims
• Infant : less than 1 year old
• Child : 1 year to adolescent
(12 to 14 years old)
5. D : Danger
1. Check scene is safe
2. Remove source of danger if possible
3. Only remove victim as last resort
4. Wear personal protective equipment
5. Make sure you, the victim and any
bystanders are safe
6. R : Responsiveness
Determine unresponsiveness
– gently stimulate the infant’s and ask loudly “Hello.
Are you Okay” and see if there is any response.
– If the child is responsive, he / she will answer, move
or moan. Leave him in the position in which you find
him (provided he is safe). Check his condition and
seek help. Reassess him regularly.
7. S : Shout for help
• If the child is unresponsive or only gasping :
– Shout (Call) for help, if available only!!!
o If not available, provide BLS for 5 cycles
before activating EMS yourself
– Position the victim: hard & comfortable
surface
Cardiopulmonary arrest in infants is most commonly associated with hypoxia,
about 1 minutes of CPR may restore oxygenation and breathing or prevent
the infant with respiratory arrest from developing cardiac arrest.
8. Position Victim:
• Victim found on the floor should be initially
managed on the floor.
• Face down victims shall be rolled over to the
supine position
• Air filled mattresses should be deflated
during CPR
9. A: Airway
• Check Airway :
–Look in mouth for foreign body
–Remove if visible only
10. Open the airway:
head tilt-chin lift
Do not hyperextend the neck as
the trachea may collapse and
obstruct the airway.
11. B. Breathing
Determine breathlessness by look,
listen & feel (Not more than 10s,
count thousand 1 to 5) )
•Look for rise and fall of chest and abdomen
•Listen for exhaled air
•Feel for exhaled air flow on your cheek
Note: Periodic gasping, also called agonal gasps, is not breathing
12. B. Breathing
If infant is breathing normally:
place in recovery position and activate
EMS
13. B. Breathing
• If infant is not breathing normally or has
only occasional gasps :
Give 5 Rescue Breath
• Mouth over nose & mouth
• 5 breaths at 1 breath per sec
14. C. Circulation
Determine pulselessness :
o Feel brachial / femoral artery
with index and middle fingers
o should not take > 10s , count
thousand 1 – 5
Infant : Brachial or femoral pulse
Child : Carotid or femoral pulse
15. C. Circulation
If pulse present :
– Deliver rescue breathing of 12 to 20 breaths/minute, Count
thousand 1, thousand 2, thousand 3 in between each breath.
– Check pulse & breathing every 2 minutes.
If no pulse or heart rate < 60 per minute and
signs of poor perfusion:
– Begin chest compressions
16. Landmark for
chest compression
• Lower half of the sternum
Two-finger chest compression
technique (1 rescuer)
Two thumb –encircling hands
technique (2 rescuer)
17. External chest compression
Parameters
• Infant :
– Using 2 fingers (tip of fingers)
– Lower half of the sternum
– At least 1/3 the depth of the chest (4cm)
– At least 100 per minute but not > 120/min
• Child :
– Using 1 or 2 hands
– Lower half of the sternum
– At least 1/3 the depth of the chest (5cm / 2
inches)
– At least 100 per minute but not > 120/min
18. External chest compression
Parameters
• Compression to ventilation ratio
– 15:2 ( single or 2 rescuers) = 1 cycle
• Active chin lift is often needed during
ventilation
19. Activate the EMS
• After 5 cycles (1 minutes) of CPR,
check pulse
• If rescuer is alone, activate the EMS
system after initial 5 cycles of CPR
20. R-UNRESPONSIVE
D-DANGER?
S-Shout for HELP & Activate EMS if available only.
Or send 2nd rescuer to get AED / defibrillator (if available)
Give 5 rescue breaths
A-Check Airway , Open Airway
If no breathing / abnormal breathing If normal breathing
Place in recovery
position & monitor
C-Check pulse (brachial / femoral) (not >10s)
Perform CPR at 15 compressions : 2 ventilations. Activate EMS
after 5 cycles if lone rescuer. Recheck pulse every 5 cycles .
Repeat cycles of CPR till AED / defibrillator / Help arrives
B-Assess Breathing by Look, Listen & Feel (not > 10s)
Pulse absent Pulse present
Give rescue breathing at 12 – 20 / min,
Recheck pulse & breathing every 2 minutes
Start CPR with chest compressions
Place in recovery position if pulse & breathing present
23. Assess Severity
Severe Airway Obstruction
( Ineffective cough)
Mild Airway Obstruction
(Effective cough)
Unconscious
Start CPR
Conscious
5 back blows &
5 Abdominal
Thrust
Encourage cough. Continue
to check for deterioration to
ineffective cough or until
obstruction relieved
FBAO Management
Conscious child
Repeat until foreign body dislodged or child become unconscious
24. Back Blow / Back Slap Abdominal Thrust
FBAO Management
Conscious child
31. STEP 1 Position infant on hard & comfortable place
STEP 2 Activate EMS if lone rescuer.
STEP 3 Airway :
i) Check airway
Look in mouth for foreign body. Remove it with the little finger if seen.
ii) Open airway by head tilt chin lift
STEP 4 Try to ventilate. If the chest does not rise after the first breath, reposition the infant’s head and re-
attempt ventilation (2nd breath). If the 2nd breath is still unsuccessful, start 15 chest compressions.
(This showed airway is obstructed)
STEP 5 After 15 chest compressions, look in mouth for foreign body; remove it if seen. Then open airway and
try to ventilate. If the chest does not rise, reposition head and try to ventilate again.
Repeat STEPS 4 to 5 till the foreign body is dislodged or you are able to ventilate.
If you are able to ventilate the victim, proceed to pulse check and chest compressions if necessary.
If pulse present, proceed to check for breathing by look, listen & feel. Deliver 12 – 20 breath/ min if infant is not
breathing. Check for pulse every 2 min until infant regain pulse & breathing normally
If the victim resumes effective breathing, place in the recovery position and monitor closely until rescue personnel
arrive.
FBAO Management
(Conscious >>Unconscious Infant)
32. RECOVERY POSITION
• Victim is in the true lateral position.
• Head in the dependant position.
• Position is stable.
• Position is safe and comfortable to the
victim.
