Child CPR. It’s a scenario every parent and caregiver dreads. While it’s thankfully rare, a child can suffer a cardiac arrest. Acting quickly and correctly in such a moment can be life-saving.

In this article, we’ll share exactly what to do. What are the key differences between child and adult cardiac arrest? Can you use an AED (defibrillator) on a child? And what about pregnant women? We’ll cover it all, step by step.

How Common is Cardiac Arrest in Children?

Fortunately, cardiac arrest in children is rare. For context, data from the American Heart Association shows that of the 350,000 out-of-hospital cardiac arrests in the U.S. each year, around 7,000 (or 2%) involve a child.

While these events do happen, they are far less common than in adults.

What Causes Cardiac Arrest in Children?

The causes of cardiac arrest in children often differ from those in adults. In most cases, it is the result of breathing problems or shock, which eventually causes the heart to stop. The Resuscitation Council UK (RCUK) states in their Paediatric basic life support Guidelines: “Cardiac arrest in infants and children is most commonly due to hypoxia (asphyxial arrest)”. Asphyxial arrest refers to a cardiac arrest caused by a lack of oxygen, a cause much less likely in adults. For this reason, rescue breaths are a high priority in paediatric resuscitation.

A sudden cardiac arrest without warning is more typically linked to underlying heart conditions, such as congenital heart defects.

How is Child CPR Different from Adult CPR?

The guidelines for performing CPR (Cardiopulmonary Resuscitation) on a child are different from those for an adult. According to the Resuscitation Council UK (RCUK), the key difference is how you begin:

• For a child: You always start with five rescue breaths before moving on to chest compressions.
• For an adult: You begin immediately with chest compressions.

This is because cardiac arrest in children is often caused by a breathing problem, whereas in adults it’s usually due to a primary heart condition.

After the five initial rescue breaths, you give 15 chest compressions, followed by two rescue breaths. You continue this 15:2 ratio. For adults, the ratio is 30 compressions to two breaths. This difference ensures children receive more oxygen, which is vital.

These guidelines apply to children from the age of one. For infants, the same steps apply, but chest compressions should be performed with two fingers.

What if I’m not trained in Child CPR?

If you have not been trained in child resuscitation, it is better to follow the adult CPR guidelines than to do nothing. Just ensure you use gentler compressions and smaller rescue breaths.

Can You Use an AED on a Child?

Yes. If an AED is available, it is important to deploy it on both adults and children experiencing cardiac arrest. Research has shown that a child’s chance of survival is significantly higher when an AED is deployed.

Many people hesitate to deploy an AED on a child, fearing they might cause harm. However, as lead researcher Dr. Rossano noted in a study highlighted by the American Heart Association, “People don’t want to do something wrong. But anything you do helps.”

The Resuscitation Council UK (RCUK) states in its 2021 guidelines: “While we continue to stress the importance of high-quality ventilations and chest compressions, we recommend using AEDs on all children if feasible.”

Which AED Should Be Used on a Child?

For children under eight years old, it is preferable to deploy an AED with child-specific features (like pediatric pads or a child mode). This is because the standard shock delivered by an adult AED is higher than what is recommended for young children. If a child-mode AED is not available, you can and should deploy a standard adult AED. Doing something is always better than doing nothing.

When using adult pads on a small child, you may need to place one pad on the centre of the chest and the other on the back, between the shoulder blades, to ensure they don’t touch.

For children over eight, a standard adult AED is always recommended.

Some AEDs, like the Philips FRx, have a special child key that adjusts the shock level without needing to change the pads, saving valuable time.

Can You Use an AED on a Pregnant Woman?

Yes. If a pregnant woman suffers a cardiac arrest, it is extremely important for both the mother and baby to deploy an AED as quickly as possible. The Resuscitation Council UK (RCUK) advises following the standard adult CPR protocol. The shock is safe for the baby.

If the woman is more than 20 weeks pregnant, it’s recommended to tilt her belly slightly to the left to improve blood flow to the heart.

Summary

Cardiac arrest in children is rare, but it can happen. For example due to underlying heart conditions. In children, breathing problems often play a bigger role. That’s why effective CPR and rescue breaths are especially important for children. If an AED is readily available, it can be a life-saving tool.

Key Takeaways

• Cardiac arrest in children is rare and often caused by breathing problems.
• Because of this, starting with 5 rescue breaths and providing effective ventilation is crucial during child CPR.
• If an AED is available, it can be a life-saving tool and should be used.
• For children under 8, deploy an AED with a child mode or pediatric pads if possible. If not, deploy a standard adult AED.
• Always call emergency services first. Never let fear stop you from acting. Doing something is always better than doing nothing.