Basic infant resuscitation procedures include initial assessment, initiation of cardiopulmonary resuscitation, and activation of emergency medical care. Basic baby resuscitation procedures are performed by either trained lay people or medical staff.
Cardiac arrest in infants is most commonly caused by respiratory failure, in contrast to adults in whom the most common cause is ischemic cardiovascular disease.
Resuscitation of babies, as well as children and adults, begins with an assessment of safety for rescuers, as well as the patient himself - away from danger. The environment must be safe for both the victim and the rescuer, so that the child is out of danger and the rescuer does not become another victim.
We then check the baby's consciousness by lightly pinching it, monitoring for any reactions (eye opening, crying, frowning, or no reaction).
The airway should then be cleaned — check for any contents in the mouth and nose, and if so, clean it and open the airway.
Opening the baby's airway means placing the head in a neutral position, or sniffing position (Figure 1)
Fig.1 Sniffing position
After opening the airway, check the airway - the rescuer puts the ear above the victim's mouth, and the eyes follow the lifting of the chest and all this in just 10 seconds, the method I look, listen, feel. Watching your chest lift, listening to the noise of breathing and feeling the exhaled air If the baby is not breathing, 5 initial breaths should be started immediately. Each breath lasts 1 to 2 seconds. The volume of the breath must be sufficient to see the lifting of the chest, and for babies the amount of air we already have in our mouths is sufficient.
In babies, the rescuer covers the baby's mouth and nose with his lips. (picture 2)
Fig.2 Mouth-to-mouth and nose ventilation
Next we check the pulse. We check the pulse in babies over the brachial artery in the upper arm or over the femoral artery in the groin (Figure 3).
Fig.3 Checking the baby's heart rate
If the pulse is absent for more than 10 seconds or is insufficient (less than 60 beats per minute) with signs of poor perfusion, external cardiac massage should be initiated. Signs of poor prefusion are: pallor, unresponsiveness to stimuli, and weakened muscle tone.
Mjesto kompresije kod beba je donja polovica sternuma tj. sredina zamišljene crte koja spaja mamile. Grudni koš se utiskuje za 1/3 njegove dubine. Očekivani broj kompresija na grudni koš je 100-120/min. Kompresije se provode sa dva prsta ili sa palčevima uz obuhvaćanje grudnog koša rukama (slika 4).
Fig.4 Compressions in the baby
It is necessary to avoid excessive ventilation and not to interrupt the chest compression for more than 10 seconds. The number of compressions in babies must be 100-120 per minute. Compression to ventilation ratio: 15 chest compressions then 2 ventilations.
After 1 minute of carrying out basic resuscitation measures, the rescuer must call an ambulance. Since this is a baby, the rescuer can take the victim to the phone and continue with the basic resuscitation procedures.
Upon arrival of the ambulance, the complete procedure (BLS) is repeated, ventilation is performed with a mask, with adequate oxygenation, and the baby is connected to the monitor. In case of ventricular fibrillation or pulseless ventricular tachycardia, defibrillation must not be delayed, and energy is dosed according to body weight, ie. 4J / kg.
BASIC LIFE SUPPORT MEASURES (BLS)
Awareness check (baby pinching)
Airway opening procedures ↓
Method I watch, I listen, I feel
5 initial breaths
Check pulse (no longer than 10 seconds, in baby check pulse over brachial and femoral artery)
15 chest compressions: 2 ventilations
After 1 minute, call the HMP