Basic Life Support for an Infant

Developed in partnership by: RCH Medical Education & Nursing Education

Medical Education Jan 2014 v1

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This package should be completed in conjunction with:• Australian Resuscitation Council Paediatric Guideli

nes• Basic Life Support – Child eLearning package• Basic Life Support skill stations (RCH simulation

program & skills lab)• Practical BLS (RCH level 2) assessment• Practical ‘First 3 minutes’ team training scenario

Disclaimer:This eLearning module has been developed by The Royal Children's Hospital. The information contained in this module is intended for the use of healthcare professionals only. The Royal Children's Hospital does not accept any responsibility, and will not be liable for, any inaccuracies, omissions, information perceived as misleading, or the success of any treatment regimen detailed in this package. eLearning modules may not be altered, copied or reproduced without permission. Menu NextPrevious

Introduction

This learning resource has five components:1. Before you start - reflection activity 2. Watch and Learn• DRSABC approach to paediatric resuscitation• Management of the infant airway• Effective cardiac compressions in an infant• Importance of Leadership

3. Practical tips4. Patient safety tips5. Resource page should you want further

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Before you start

You are called to an 8 week old infant admitted with severe bacterial pneumonia.- RR 82 min-1, marked WOB, increasingly frequent

apnoeas.

You think respiratory arrest is imminent.

• How confident do you feel delivering effective life support until the emergency team (MET) arrive?

• Which role will you take in the resuscitation?

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DRSABCThere are 6 steps to Basic Life Support:

1. Danger and Response 2. Send for Help3. Airway 4. Breathing5. Circulation

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Danger and ResponseScan the environment for DANGER to self or othersCheck for a RESPONSE to determine conscious state

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Send for Help• Shout for local help•Press emergency buzzer•Call MET – dial 777, State:

“MET call” “Building” “Floor” “Ward/area” “Room number” and “Bedcard unit”

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AirwayAirway opening maneuvers:•Head neutral position•Chin lift• Jaw thrust•Oropharyngeal airway (may be inserted to maintain airway patency)

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Oropharyngeal Airway

Sizing Oropharyngeal airway

Correctly positioned oropharyngeal airway

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BreathingLookListenFeel

If unresponsive and NOT breathing normally, commence bag-mask ventilation

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Breathing

One hand technique:• Thumb & forefinger used to hold mask maintaining a good seal• Remaining fingers placed along jaw line maintaining chin lift to

open the airway. Avoid placing fingers into soft tissue of throat as you may obstruct the airway.

• If maintaining a seal is difficult, 2 hand technique should be used with 2nd person to operate self-inflating bag.

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Practical TipsIf you fail to achieve good rise and fall of the chest, check:•adequate seal

• correct head in neutral position (not over or under- extended

• self-inflating bag is correctly assembled & working• inflation pressure is adequatePatient Safety TipsThe Self inflating bag CANNOT provide supplemental oxygen in spontaneously breathing individual

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CirculationSpend no longer than 10 sec feeling for a pulse.

Commence chest compressions if infant is unresponsive and not breathing normally.

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2 responder CPRRatio 15:2

Hand encircling chest

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1 responder CPRRatio 30:2

2 finger technique

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Practical Tips• Ensure firm surface or board under infant• Allow for complete recoil of chest between each

compression• The person performing chest compressions

should count out loud

Patient Safety TipsIn all resuscitations there should be a clear leader (this person may change as increasing expertise becomes available)

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Leader Role & Responsibilities• Ensure MET call is made• Ensure continuous effective CPR being delivered• Ensure monitoring is attached• Allocate additional staff to draw up drugs, fluids &

scribe• Announce rhythm to team (shockable, non-

shockable)• Provide handover to MET team

(ISBAR)

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Anticipatory CareIt is the responsibility of initial healthcare responders to deliver continuous effective CPR until emergency help arrives (MET).

In addition, staff can anticipate & prepare for:• IV or IO access• Administration of adrenaline

(0.1ml/kg 1:10,000 Adrenaline)• Fluid bolus• Intubation

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Resources for additional reading• Australian Resuscitation Council Paediatric Guidel

ines• Basic Life Support (RCH Level 2) information

package 2014 – nursing education• APLS algorithms

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Confirm your knowledge1. For an unconscious infant, the head position to open the

airway is:a) Hyper extended positionb) Sniffing positionc) Neutral position

2. If the individual is spontaneously breathing, supplemental oxygen should be NOT be provided by:a) Hudson face maskb) Self inflating bagc) Nasal prongs

3. The correct ratio for compressions to breaths when 2 rescuers are performing CPR in the healthcare setting isa) 15 compressions : 2 breathsb) 30 compressions : 2 breathsc) 5 compressions : 1 breaths Menu NextPrevious

Certificate of Completion

Enter name here

has completed the eLearning module “Basic Life Support –

Infant”on 08/05/2023