CPR for a child: Chest compressions (one-hand technique)

Authors: Rednenko V.V.

Editor: Rednenko V.V.

Clinical situation:

While at the train station, you heard a call for help. As you approached the scene, you found a group of people surrounding a child (appearing to be about 8-10 years old) lying on the floor. There are no visible damages. To your question “What happened?”, the witnesses told you that the chid suddenly fell.

Equipment for the practical skill:

• protective medical gloves;
• СPR simulator.

The procedure for performing a practical skill

• Place the child face-up on a firm, flat surface.
• Position yourself at the side of the child on your knees, so as to ensure proper chest compressions.
• Free the chest area from clothing (especially if it has buttons or zippers).
• Determine the compression point on the sternum:
  • place the second and third fingers of both hands in a V-shape from the jugular notch to the xiphoid process to divide the sternum into three equal parts;

• • the compression point is the point between the lower and middle third of the sternum (the index finger of the hand located closer to the xiphoid process is located on it);
• Position your hand at the selected compression point so that:
  • the center of the palm heel coincides with the selected point on the sternum;
  • the palm was perpendicular to the midline of the sternum;
  • the line of contact between the palm heel and the sternum coincided with the midline of the sternum.

• • pull your fingers upward until only the heels of your palm touch person’s sternum along the midline.
  • the other hand can be positioned to maintain an open airway throughout

or to stabilise the compression arm at the elbow.

• Position your body so that your shoulder are directly over your hand (vertically) and keep your arm straight.
• Keeping your arm straight, push down using your body weight at a rate of 100-120 compressions per minute to a depth of one third of the anterior-posterior diameter of the chest.
• After each compression, release all the pressure on the chest without losing contact between your hand and the sternum (let the chest completely return to its normal position).
• Maintain a smooth, steady down-and-up rhythm and do not pause between compressions.
• After15 compressions, tilt the head, lift the chin, and give two effective breaths.
• Continue compressions and breaths in a ratio of 15:2.
• When performing CPR by cycle, including chest compressions and rescue breath in a ratio of 15:2, as you give compressions, count to 15. You can count out loud or silently. If you count silently, then say the count 13, 14, 15 out loud to orient the assistant giving the breathing.
• Continue compressions so that the pause, including the rescue breath, is no more than 10 s.
• Two or more rescuers should change the rescuer performing chest compressions frequently 
• Individual rescuer should  switch hands  and two or more rescuers should change the rescuer performing chest compressions frequently to avoid fatigue
• Do not interrupt CPR at any moment unless there are clear signs of circulation (movement, coughing) or when exhausted.