Step 5. Do 30 chest compressions. Quickly remove or arrange clothes so that you can see the infant’s chest. Be sure infant’s clothing doesn’t cover her face. Place your hands on the infant’s sides, with your thumbs side by side just below the nipple line. Your fingers will wrap around the infant’s back. (Alternate technique: Place two fingers of one hand just below the nipple line in the middle of the chest. Your fingers need to be in line with the breastbone—not crossways to it, and well above the lower end of the breastbone.) Push straight down on infant’s breastbone. Compress about 1 ½ inches. Count out loud while you push hard and fast. You should push at a rate of 100-120 pushes per minute. After each push, release pressure on the chest so the chest can return to its normal position.
• Rescuer must see infant’s face and chest (arrange clothes). Press infant’s chest straight down about 1 ½ inches.
• Imagine a line connecting infant’s nipples. Fingers are placed lengthwise—not crosswise—just below the nipple line. Finger placement is the same as used in Choking Infant Rescue chest thrusts.
• Chest compressions act like a substitute heart. Pressing on the heart squeezes blood out of the heart and into the arteries to take it around the body. Push hard and fast so the “substitute heart” can do its job. Release the pressure after each push so blood can refill the heart. Do not stop doing chest compressions except for a few seconds to give breaths.
Step 6. If you know or suspect the infant may have choked, open the infant’s mouth widely and look for an object, such as food or toy. If you see an object, carefully remove it with your fingers.
• This step may be omitted if rescuer knows the infant has not choked, such as in drowning.
Step 7. Open the airway by gently tilting the head back and lifting the chin up. Put 1 hand on the forehead and 2 fingers of your other hand on the infant’s jawbone.
• Use 2 fingers when lifting chin. Put fingers on jawbone, not on soft part of neck or under chin.
• Remember not to tilt the head back too far or you will kink the airway.
Step 8. Give 2 rescue breaths. While holding airway open, cover the infant’s mouth and nose with your mouth and create an airtight seal by pressing your lips firmly against the infant’s face. Blow gently about 1 second for each breath. Watch for the chest to rise as you give each breath. If the infant’s chest did not rise after the first breath, reposition the head using the head-tilt and chin-lift and attempt to give another breath. Proceed to chest compressions after 2 breaths even if breaths failed to cause the chest to rise.
• Rescue breath is exhaled air, but there is enough oxygen in exhaled air to keep victim oxygenated. If chest doesn’t rise, airway is not open. It could be the head position, or something could be obstructing the airway.
PAGE 36 | GRANDPARENTS: GETTING STARTED INSTRUCTOR MANUAL
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