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Basic Cardiopulmonary Resuscitation and Treatment of Foreign Body Obstruction in Infants 嬰兒基本心肺復甦術及異物阻塞處理

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Basic Cardiopulmonary Resuscitation and Treatment of Foreign Body Obstruction in Infants 嬰兒基本心肺復甦術及異物阻塞處理

2024/3/21

Cardiopulmonary arrest is most common in premature infants, such as spontaneous apnea, choking on milk, airway obstruction caused by accidental or suspected ingestion of jelly or buttons. The primary life-saving operation for infants is to keep the airway open, which can restore the heartbeat and blood circulation in most babies.

Basic CPR steps for infants

  • When it is found that the baby's face turns white, black and has poor mobility:

Step 1:

Pat the baby's chest first to see if it responds.

Step 2:

Flick the baby's heel to make it cry.​

  • Having a reaction --> sent to hospital.
  • No reaction --> cry for help --> first aid for 2 minutes --> call emergency medical network (119).

Step 3:

Place the baby on a hard table or bed before an ambulance arrives.

Step 4:

Open the baby's respiratory tract to keep it unobstructed:

1.Head-tilt/chin-lift

Place one hand giving pressure on the forehead and the other on the chin. Lift the chin up (if the neck is injured, do not use this method).

2.Jaw-thrust

 (Suspected neck or spinal cord injury in the baby)

Place both hands on the chin corners of the baby. Lift the chin up with the strength of your hands and open the mouth.

 

 

 

  • If the chest does not rise and fall, check whether there is any foreign body blocking the baby's mouth. If any, remove the foreign body with fingers first, and carry out the following treatment:

Treatment of foreign body obstruction

Step 1: Remove foreign bodies

Move your baby's tongue and chin, and use your index finger to remove foreign objects from your baby's mouth or throat.

Step 2: Pat the back

Support the baby's chin, neck and chest with the right palm, making its body incline downward with face down, and hit 5 times with the heel of your left hand in the middle of the scapula.

Step 3: Turn to lying on the back

Support the back of the baby's head with your left palm, place it between your arms to avoid shaking, and turn it into a supine position.

Step 4: Press the chest

Let the baby lies on your left hand, with its head down and feet up, pressing the lower half of the sternum with two fingers of your right hand, pressing its chest 5 times quickly.

Step 5: Assess breathing

See if the baby’s chest is rising and falling, hold your ears close to its nose and mouth, listening and feeling if it is breathing.

Step 6:

When you find that the baby is not breathing, cover the baby's mouth and nose with a mask, and blow 2 breaths (each breath takes 1 seconds, use the corner of your eye to see the rise and fall of the baby's chest, and then blow the second breath after its chest falls completely).

Step 7:

  • Reassess the baby's life signs.
  • Use your index and middle fingers to touch the baby's Brachial Artery to measure its pulse or to see if the it has spontaneous breathing, coughing, or body movements.

Step 8:

If the baby has no pulse or spontaneous breathing, start  cardiac massage immediately:

  • Press the chest at 1/2-1/3 of the depth vertically with the index finger and middle finger (or with both hands around the chest) at the lower transverse finger of the line between the two nipples of the baby.
  • Count from 1 to 3 loudly when pressing down (fast pressing).
  • The movement between press down and release must be smooth and rhythmic, with 30 presses for every 2 blows (2:30).
  • Continue to do it for 5 cycles (about 2 minutes), and then stop to check the pulse.
  • If the baby still has no pulse, continue blowing and massage until the ambulance arrives. If the baby has spontaneous breathing and pulse, stop first aid, turn it into a resuscitation position and maintain its airway unobstructed, keep it warm and send it to the hospital immediately or wait for the emergency medical services.
Reference
  • 美國心臟協會(2020).CPR與ECC準則。https://cpr.heart.org/-/media/CPR-Files/CPR-Guidelines-Files/Highlights/Hghlghts_2020ECCGuidelines_Chinese-Traditional.pdf
  • 黃庭紅(2022).兒童事故傷害及其護理.陳月枝總校閱,實用兒科護理(九版二刷,868-877頁).華杏。
製作單位:兒童醫院 編碼:HE-50056-E
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