Everyone wants the best for their child, and keeping them safe is a top priority. But accidents happen and emergencies can strike at any time. Knowing how to do Cardiopulmonary resuscitation (CPR) is one of the best things you can do to save their life (and brain). But when it comes to our little ones, knowing the steps to do CPR is not always enough. Making sure you know how to do effective rescue breaths can make a huge difference in how things turn out.

As paediatric intensive care nurses, we’ve seen first hand how effective CPR and rescue breaths can significantly increase chances of survival and reduce the risk of long-term complications. However, the majority of people don't feel confident to start CPR, even when it’s a family member. If this is you, don’t stress about it — arm yourself with knowledge instead!

What is CPR and How Does it Save Lives?

CPR is a life-saving technique to move blood, but most importantly oxygen, around the body when the heart can’t. It is a combination of rescue breaths to get oxygen into the lungs and compressions to pump the heart and move blood and oxygen to the vital organs. Keeping blood moving by doing CPR is key to buying time while waiting for first responders to arrive and to give your child the best outcome.

Here are 3 key Reasons Why Effective Rescue Breaths are So Important For Children and Babies

01. CPR is Needed Because Breathing Issues and Blocked Airways Stop Their Heart

Unlike adults, who usually need CPR due to problems with their heart, the most common reason kids need CPR is because of airway or breathing issues. These issues stop oxygen getting into their body and to the heart — which stops the heart working properly and blood can't move around the body. It’s a scary cycle.

The most common causes of breathing issues and blocked airways is drowning, suffocation and choking, and respiratory illnesses.

Drowning: Young children can drown in any body of water that’s over 5cm deep. This means that, sadly, many kids have a drowning or near drowning event in a seemingly harmless body of water — like a bath or paddling pool. Drowning is silent, so parents may not know their child is drowning until they’re found unresponsive.

Choking and Suffocation: Babies and kids are curious creatures, which means they explore the world by putting small objects into their mouths. Some objects can completely block off a child's airway, especially those smaller than a ping pong ball. Choking on food is also a big risk as babies and young children are still developing their eating abilities. Unsafe sleep environments can also increase the risk of suffocation. Unfortunately, half of children under 12 months who died unexpectedly had something covering their face when they were found.

Respiratory illnesses: Children have smaller airways and can more easily have breathing difficulties when they’re sick, such as with bronchiolitis, croup and asthma. A small amount of mucus or inflammation can have a big effect on their ability to breathe… and sometimes these difficulties in breathing make it impossible to take in enough air. When this happens, their heart doesn't get enough oxygen & stops working — which means CPR is critical.

02. Oxygen Levels Will Already Be Low Before They Need CPR

By the time CPR becomes necessary, childrens oxygen levels are already dangerously low. Rescue breaths are key to getting oxygen to vital organs, especially their brain. Simply performing chest compressions without rescue breaths may not be enough to prevent damage to the organs (or in some cases, death). It’s called the ‘breath of life’ for a reason!

03. Rescue Breaths Reduce the Risk of a Brain Injury

The brain loves oxygen, without it for 4 to 6 minutes there can be irreversible serious damage. By combining chest compressions with rescue breaths when doing CPR, a steady flow of oxygen can reach the brain, improving your little one’s chances of a better outcome.

When we care for children who end up on life support after CPR at home, a major part of their treatment plan is protecting their brain. Children can survive after a cardiac arrest, however, whether they’ll end up with a serious disability greatly depends on how long they were without oxygen. Some children can even go on to live normal lives — but the odds of this outcome is hugely dependent on effective CPR and if it was started early.

How to perform CPR

Now that we understand the importance of rescue breaths, here is how to perform CPR on babies and children with effective rescue breaths.

No matter who or where you are, whether a doctor in the hospital or a parent in the community, everyone follows DRSABC. And most importantly always try to stay calm.

D - Danger

Assess the environment for danger, take steps to prevent any further harm from occurring.

R - Response

Assess a collapsed person for a response to voice and touch. Speak loudly and say your child's name. Squeeze your child's toes to assess for touch.

S - Send for Help

Call 111 for an ambulance or ask someone to send help (make sure you specifically identify the person). Tell 111 it is a collapsed baby/child and the location.

A - Airway

ASSESS and OPEN the airway. When people become unconscious their tongue can flop downwards and cover the airway. That is why it’s important for the child's airway to be opened before assessing their breathing.

If you can see something in their mouth, use two fingers to sweep it out.

The techniques to open the airway is different for babies (under 12 months) and children (over 12 months).

Babies: Place their head in a neutral position (keeping their nose to the sky is an easy way to remember the right position).
Children: Use a head tilt and chin lift. Place one hand on their forehead and use the other hand to lift their chin.

B - Breathing

Look, listen and feel for signs of normal breathing.

If your unresponsive child is gasping or not breathing normally START CPR — you don’t need to check for a pulse.

C - Start CPR (30 compressions:2 breaths)

Perform 30 chest compressions. Once you’ve given the chest compression give 2 rescue breaths then re-start compressions.

Perform TWO breaths (Babies - cover the mouth and nose with your mouth. Child - cover the mouth with your mouth and pinch the nose).

You only need to breathe a small amount of air. For babies this is around the amount you use to blow out a candle.
If there is no chest rise after the first attempt, go back and make sure their airway is open. You may need to use the opening airway techniques again. If there’s no chest rise both times, move on to compressions

Knowing how to not only perform CPR but also give effective rescue breaths is one of the best ways to prepare for an emergency. It not only buys your child time while waiting for an ambulance, it’s key for better outcomes and reducing the risk of a brain injury.

Parents and family members are more likely to start CPR when they’ve had recent baby and child CPR training — to be prepared for anything, book a child and baby first aid course today.

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3 Key Reasons Why Rescue Breaths Are Vital for Saving Babies and Children