CPR Protocol for Infants

Initial Assessment and Actions

• The American Heart Association recommends verifying scene safety before approaching the infant, checking for responsiveness by tapping the infant gently, shouting for nearby help, and activating the emergency response system via mobile device if alone 1
• The American Heart Association suggests looking for no breathing or only gasping and checking pulse simultaneously, determining if pulse is definitely felt within 10 seconds 1, 2

Response Based on Assessment

• If the infant has no normal breathing but a pulse is present, the American Heart Association recommends providing rescue breathing at a rate of 1 breath every 2-3 seconds (20-30 breaths/minute) 1, 4
• If the heart rate is less than 60/min with signs of poor perfusion, the American Heart Association suggests starting CPR 1, 2

Proper Chest Compression Technique for Infants

• The American Heart Association recommends compressing in the middle of the chest, just below the intermammary line, using a 2-finger technique, and compressing at least one-third of the anterior-posterior diameter of the chest 3, 5
• The American Heart Association suggests maintaining a rate of 100-120 compressions per minute and allowing complete chest recoil after each compression 4, 6, 7

Ventilation Technique

• The American Heart Association recommends opening the airway using a head tilt-chin lift maneuver and using a mouth-to-mouth-and-nose technique for infants 7

Two-Rescuer CPR for Infants

• The American Heart Association suggests performing cycles of 15 compressions and 2 breaths when two rescuers are present 1, 6
• The American Heart Association recommends changing compressors every 2 minutes or sooner if fatigued to maintain quality 4, 7

Advanced Life Support Considerations

• The American Heart Association recommends considering bag-mask ventilation with oxygen, cardiac monitoring to identify shockable rhythms, and IV/IO access for medication administration for healthcare providers with appropriate training 4, 6
• The American Heart Association suggests an epinephrine IV/IO dose of 0.01 mg/kg (0.1 mL/kg of 0.1 mg/mL concentration) 4

Common Pitfalls to Avoid

• The American Heart Association recommends avoiding inadequate compression depth, ensuring proper depth of at least one-third of chest diameter 3
• The American Heart Association suggests minimizing interruptions in compressions, maintaining 100-120 compressions/minute, and rotating compressors every 2 minutes 4, 6, 7