How to Take CPR for Infant?

In CPR neonatal, positive pressure ventilation of neonatal lungs is the most important and influential measure. The primary goal of neonatal resuscitation is to ventilate the neonate's lungs with positive pressure. Reasonable collocation of personnel and good team cooperation guarantees the success of neonatal resuscitation.

Use the method of raising the head and chin to clear the airway. Since the mouth and nose openings of the baby are small and the positions are very close, the rescuer can use his mouth to close the mouth and nose openings of the baby and perform "mouth-to-mouth" nasal breathing. The baby's ligaments and muscles are loose, so the head should not be tilted back too much to prevent the trachea from being compressed and affecting the smoothness of the airway. The chin can be supported with one hand to keep the airway straight.

Ⅰ. A clear airway is needed at the beginning of neonatal cardiopulmonar resuscitation

1. Set up the posture for recovery. Place the newborn in a warm area with a radiant heat source, dry the amniotic fluid and bloodstains on the body, and remove the wet wipes. The newborn lies on its back, with shoulder height 2~3cm. The newborn has a slight neck extension and supine position to make the airway unobstructed.

2. Absorb the mucus from the oral cavity and nasal cavity. When sucking oral snot, it should be noted that the suction time should not exceed 10 seconds, the pressure should be moderate, and the straw insertion depth should be appropriate. When using mechanical suction, the suction pressure should be controlled. The negative pressure when the suction tube is closed does not exceed 100mmHg.

3. When using CPR neonatal, assist the doctor with tracheal intubation if necessary to ensure the airway is unobstructed.

Indications for tracheal intubation: long-term positive pressure oxygenation; artificial respiration; airbag mask; resuscitator artificial respiration is ineffective; those who need endotracheal sputum suction and suspected diaphragmatic hernia.

Ⅱ. Induced breathing by CPR neonatal

1. Provide tactile stimulation to newborns to help establish breathing. If the newborn is not breathing spontaneously, tactile stimulation (using flicking the soles of the feet or rubbing the back) can stimulate breathing.

2. Start CPR for infants, and perform positive pressure artificial respiration if necessary. Positive pressure oxygen can be given by mask, balloon, or tracheal intubation. The two indications of positive oxygen pressure are: no breathing or only wheezing and a heart rate of fewer than 100 beats per minute.

The operation of positive pressure oxygen supply: Check the resuscitation airbag and connect it with oxygen, and choose a suitable size mask to attach it to the airbag. Put the mask on the face of the sick child to form a closed face, that is, give artificial respiration with a positive pressure of 100% oxygen for 15 to 30 seconds, at a frequency of 40 to 60 times per minute, and the time of finger pressure and release is 1:1.5. The pressure required for the first breath is 30-40 cmH2O, and then 20 cmH2O.

Ⅲ. The maintenance cycle of CPR neonatal

1. Implement chest compression

Indications for chest compression: After breathing with 100% positive oxygen pressure for 15 to 30 seconds, the heart rate is lower than 60 beats per minute or between 60 to 80 beats per minute, and there is no upward trend.

There are two methods of chest compression:

Thumb method: Press the lower 1/3 of the sternum with the thumbs of both hands; encircle the chest of the sick child with both hands; support the back of the sick child with the rest of the fingers.

Two-finger method: Use the middle and index fingers of one hand or the tips of the middle and ring fingers to compress the sternum, and use the other hand to support the sick child's back when there is no hard cushion. The compression depth should be 1.3~1.8cm, the speed should be 120 beats/min, and artificial respiration should be performed once for every three compressions.

2. Follow the doctor's advice to use drugs.