Cardiopulmonary resuscitation in children

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Working in a hospital as a medical personnel demands alot of patience and carefulness. Sometimes what we see or the kind of cases that occurs on daily bases demands an adequate attention. It may be more easier handling adult cases, knowing what their problem is, and giving out medications than being in a padiatric unit.

Yesterday was an unforgettable day in my life that left me speechless. I work as a medical laboratory scientist in a well known hospital in Awka, Anambra state.

I was actually on a night duty that yesterday when a child was brought to the hospital unconscious. The parents of the child were unable to give account on what actually happened to the child. That day was actually my first time to see a doctors resuscitating a child.

Throughout my stay in the university I have always been reading about CPR(cardiopulmonary resuscitation). Though the problem we have about Nigerians education is the inability to practice most of the things you read in school. This child was something else. Seeing a child being resuscitated for up to six good times left me speechless. At a point I taught it was over. But seeing the doctor making out an effort to make sure the child is brought back to life still amazes me.

After the resuscitation that almost took the whole night. My question now is how can we be able to do the same if probably we find ourselves where hospital is not within our reach. Because to me that child would have died if doctors were not there to revive him

Today I will be talking on cardiopulmonary resuscitation in children and how you can revive an unconscious child.

what is cardiopulmonary resuscitation

It is simply the act of saving a child when his or her breathing or heartbeat stops.
This is usually done when a child is drowning, suffocating, choking or probably sustained an injury. It is the act of rescuing breathing of the child to ensure efficient functioning of the lungs by circulating oxygen to the needed part.

It also Involves chest compression to enable adequate flow of blood to the body and to the vital organs. This resuscitation is done depending on the age of the child. For those who are below one year of age.

Make sure that the head is in a neutral position. Place your finger under the line of the child's chin and lift it up. To enable efficient airway, do not push or tamper with the soft tissue under the chin as this may prevent passage of air.

For children more than one year of age. Tilt the head of the child and lift the chin for easy opening of airway. Then listen and observe the child condition by looking at the face of the child and their chest. Check if there is chest movement and observe the nose and the mouth for breathing sound. If the child is actually breathing normally turn them on their side and check for efficient breathing.

If paradventure the child is not breathing very well, remove any obstruction from the child's mouth if any. Give five rescue breath and note if there is sign of gag or cough from the child as this is an indication that the child is still alive.

If there is no sign of life, chest compression should be started immediately to avoid further delay. Combine both the rescue breath and compression at the same time. To every 30 compression 2 rescue breath are given.

For children under one year of age, the compression is done on the breast bone with the two tip fingers not the whole hand. The depth at which the compression are being given is very important. If the appropriate dept of 4cm cannot be achieved by using the two fingers then you should consider using the heel of the hand.

Place the heel of the hand on the lower third of the breastbone. The finger can be lifted to ensure the rib has not been pressurized. Keep your arm straight and position yourself while compressing the breastbone down to 5cm. Continue this process until the child shows a sign of coughing or breathing.

Getting to understand the things to do when a child needs to be resuscitated, it is also necessary to understand the pathophysiology involved in CPR.

pathophysiology

CPR is mainly done to keep the vital organs found in the body alive. It is done mainly on people with cardiac arrest. This is to ensure adequate supply of oxygen to the body and mainly the vital human organ. It is done to generate pressure gradient between the vein and artery. A delay in CPR for more than one hour can result to a permanent damage to the brain cells making it non functional.
The major function of CPR is to enable blood flow to the body and the entire organs.

brief history on cardiopulmonary resuscitation

During 19th century, doctor silvester hr was able to come up with a method on how we can resuscitate a person through artificial ventilation. According to him this is done through laying the patient on their back and their arm are being raised above their head. This is to ensure efficient inhalation.

Later after doctor silvester discovery another method was discovered by Holger Nielsen in 1911 in united state.
This is done by facing the persons face down with their head facing the side.
All these were done untill 20th century when mouth to mouth resuscitation was introduced together with chest compression. The both method was first exercised in 1962 training video called the pulse of life. This video was created by James Jude, Guy Knickerbocker, and Peter Safar.

The first test conducted was on dog by Redding, Safar and jw Pearson. Then later the method was used to save the life of a child which continues from there.

in conclusion

Cardiopulmonary resuscitation is a very important thing we all should know how to do. Some cases that may demand CPR may be a little far from hospital that we have no option but to do it on our own. Many persons have lost their life on their way to the hospital. If we can understand that this is important and call it a duty we all should learn and be ready to save any life when the need for resuscitation comes up.

References
Cardiopulmonary resuscitation
How to resuscitate a child
CPR - young child (age 1 year to onset of puberty
CPR for Children


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4 comments
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Did you find out what happened to the child brought to you initially, at the end of the day?

Also, I am wondering whether there is something specific with rescue breaths to be given to children, or if they are the same as those for adults?

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As of today the child is feeling alright though he was transfused today after we discovered that his pcv level is down.
Rescue breath giving to children is the same with the adult, the little difference could be the method.
Like in children thumb or heel of the hand can be used, but in adults is a different thing altogether

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Thanks for your answer. Cheers!

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