9:59:59.000,9:59:59.000
>[NARRATOR] CPR: Child/Infant

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When normal breathing and heart function [br]have stopped, CPR can give a life back.

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This section covers CPR skills for children [br]ages one to the onset of puberty.

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>[RESCUER counts compressions]

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>[NARRATOR] At the end of the segment,

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there will be a demonstration [br]of CPR for an infant.

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>[RESCUER] 1, 2, 3, 4…

9:59:59.000,9:59:59.000
>NARRATOR] You will watch [br]as skills are demonstrated

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and then have a chance to [br]practice along with the video.

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During those practices, your instructor [br]may give you individualized coaching

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to help you achieve the best [br]results during practice.

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>[RESCUER] 7, 8…

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>[NARRATOR] Please note that although [br]barrier devices like gloves and face masks

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are always recommended,[br]you won't see them here.

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Not only is it easier for you [br]to practice without them,

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but it's also fine to give CPR [br]in an emergency without them

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as the risk of infection is very, very low.

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Let's get started.

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If you are not already seated [br]next to a mannequin,

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sit down and get ready to learn [br]skills that could save a life.

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Watch as this basic skill is demonstrated.

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You will practice it in a minute.

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The key reason for CPR is to [br]circulate oxygen to the brain.

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It is essential to get the speed [br]and force of the pumping right.

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To pump, our rescuer kneels [br]next to the mannequin

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and places the heel of her hand [br]in the center of the chest.

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Depending on the size of the child [br]and the size of the rescuer,

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she will use one hand [br](or two interlocked together)

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to get the proper chest compression[br]depth while pumping.

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She moves her shoulders directly [br]over her hand with her arm straight.

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A child's chest should compress [br]about 1/3 the depth of the chest

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or about two inches.

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The rate of pumping is fast.

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It's equivalent to 100 to 120 [br]compressions per minute.

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Let's listen to that rhythm.

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[a device ticks at the speed of [br]100-120 compressions per minute]

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A full cycle of pumping [br]is down and up 30 times.

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It helps to count out loud.

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Let's see a cycle.

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>[RESCUER] 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, [br]11, 12, 13, 14, 15, 16, 17, 18, 19, 20,

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21, 22, 23, 24, 25, 26, 27, 28, 29, 30.

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>[NARRATOR] Now get ready to [br]practice pumping along with the video.

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Kneel next to the mannequin with [br]your knees against the side of the chest.

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To pump, you'll use the heel of your hand.

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Place it on the center of the chest.

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Be careful not to press on [br]the tip of the breastbone.

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Move your shoulder over your [br]hand with your arm straight.

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Now, push down firmly [br]with the heel of your hand.

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Remember, a child's chest should be [br]compressed 1/3 the depth of the chest,

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which is about two inches.

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Avoid excessive compression depth.

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Let the chest come all the way back up[br]by removing your weight from the chest.

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Your hand should remain in contact [br]with the breastbone at all times.

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Avoid leaning on the chest [br]between compressions.

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Pumping should move [br]down and up smoothly.

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Don't jab.

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Get ready to do a 30-pump cycle [br]in time with the on-screen rescuer.

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You should count out loud too.

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Ready? Pump.

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>[RESCUER] 1, 2, 3, 4, 5, 6, [br]7, 8, 9, 10, 11, 12, 13…

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>[NARRATOR] Don't be afraid [br]to push hard and fast.

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>[RESCUER] …17, 18, 19, 20, 21, [br]22, 23, 24, 25, 26, 27, 28, 29, 30.

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>[NARRATOR] Sit back.

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Remember, pumping is fast and forceful,

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and when your shoulders are [br]over the heel of your hand,

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you won't tire as quickly.

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You will get additional opportunities [br]to practice pumping in this program.

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Rescue breathing is [br]included for effective CPR.

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Relax and watch as our rescuer [br]demonstrates rescue breathing.

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You'll practice it afterwards.

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First, she needs to open the airway [br](tilt the head and lift the chin).

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Then she pinches the nose and places [br]her mouth around the child's mouth,

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creating a seal.

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She gives one breath, [br]lasting about a second.

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She watches from the corner of her eye [br]to confirm that the chest rises as air goes in.

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She releases the seal on the mouth[br]and lets the air flow out,

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then quickly seals it again[br]and gives another breath.

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This is done faster than you might imagine.

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Watch the demonstration again in real time.

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TIME 5:00

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Now get ready to practice breathing.

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Kneel next to the mannequin’s head.

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Put the palm of one hand [br]on the mannequin’s forehead.

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With the fingers of the other hand,[br]lift the chin and tilt the head back.

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This opens the throat to allow [br]air to get into the lungs.

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Use the hand on top of [br]the head to pinch the nose.

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Open your mouth wide and cover the [br]mannequin’s mouth completely with yours,

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pressing firmly to make a tight seal.

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Take a normal breath and [br]blow air into the mouth.

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It's a quick breath of air with sufficient[br]volume to make the chest rise.

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Remove your mouth from the mannequin.

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Take another breath yourself.

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Now breathe into the mouth again.

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Take your hands off [br]the mannequin and sit back.

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This time, let's do it at the recommended pace for CPR.

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Tilt the head and lift the chin.

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Pinch the nose.

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Give breath…

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give breath…

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Remove your hands from [br]the mannequin and sit back.

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If you hear a hissing sound when you blow,

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air is leaking out from [br]the nose or the mouth.

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Be certain the nose is pinched firmly,

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the chin is lifted, and there is [br]a good seal around the mouth.

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If you don't see the chest rise during a breath,

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tilt the head and try again.

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If it still isn't rising,

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you'll need to check the airway [br]and remove any object you see.

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You've got the basics of CPR.

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Now, let's put them together:

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pumping the chest and rescue breathing.

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Kneel next to your mannequin[br]and get ready to practice.

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Position your hand on [br]the center of the chest.

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Move your shoulder over your [br]hand with your arm straight.

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Ready? Pump.

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>[RESCUER] 1, 2, 3, 4, 5, [br]6, 7, 8, 9, 1011, 12, 13, 14…

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Keep your shoulder in position over the chest

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and push down hard with your arm straight.

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>[RESCUER] …21, 22, 23, 24, 25, 26, 27, 28, 29, 30

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>[NARRATOR] Tilt head, lift chin, pinch nose.

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Make a seal over the child's mouth with [br]Yours.

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and breath one…

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breathe two…

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Pump.

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>[RESCUER] 1, 2, 3, 4, 5, 6, 7, 8…

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>[NARRATOR] Press down smoothly. Don't jab.[br]Let the chest come all the way back up.

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<[RESCUER] …16, 17, 18, 19, 20, 21, [br]22, 23, 24, 25, 26, 27, 28, 29, 30.

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>[NARRATOR] Tilt, lift, pinch.

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Breathe one…

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breath two...

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Okay.

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Sit back and relax.

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TIME 7:50

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On a real child, you would keep doing [br]CPR until the person wakes up [or]

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an AED arrives and is ready to use [br]or emergency personnel take over.

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Now that you know the essentials of CPR,[br]let's talk about when to do it.

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Watch while our rescuer [br]demonstrates the steps to take

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before pumping and breathing.

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If she finds a child who looks unconscious, [br]she must decide if CPR is needed.

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First, she checks for responsiveness.

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She taps and shouts.

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>[RESCUER] Hey! Are you okay?

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>[NARRATOR] At the same time,

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she is also noting whether the [br]child is breathing or only gasping.

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A child with abnormal or [br]absent breathing needs CPR.

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If there's no response and no breathing,[br]she moves to the next step.

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Call for help. This is essential.

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If possible, our rescuer will [br]direct someone else on the scene

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to call 9-1-1 and get an AED unit.

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She picks a specific person [br]and gives explicit instructions.

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>[RESCUER] Drew! Call 9-1-1 and get the AED!

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>[NARRATOR] no one is available to [br]make the call and the victim is a child,

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do five cycles of CPR before [br]pausing to make the call yourself.

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For the purposes of this video,

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we will only practice directing [br]someone else to make the call.

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If an AED is available and ready to go,[br]she will use it right away.

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If not, she starts CPR. [br]Chest compressions are first.

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She opens the child shirt and [br]positions her hand to pump.

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>[RESCUER] 1, 2, 3, 4…

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She continues CPR:

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until the person wakes up [or][br]an AED is available and ready to use[br]or help arrives to take over.

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>[RESCUER] …15, 16, 17…

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For now, let's practice [br]the steps for when to do CPR.

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Put a shirt or a jacket on the mannequin [br]so you can practice exposing the chest.

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If you don't have one, just pretend[br]to remove clothing from the chest.

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Sit next to your mannequin.

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If you find a child who looks unconscious,

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you need to find out [br]if they're unresponsive.

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They could just be asleep.

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Tap the child on the shoulder [br]and shout, “Are you okay?”

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>[RESCUER] Hey! Are you okay?

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>[NARRATOR] At the same time, [br]note if they are breathing or only gasping.

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If the child does not respond [br]and is not breathing,

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direct someone to call 9-1-1 [br]or the local emergency number

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to get help on the way.

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>[RESCUER] [br]Drew! Call 9-1-1 and get the AED!

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>[NARRATOR] Quickly get back to the child.

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If an AED is available and [br]ready to use, then use it.

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If it's not, start CPR.

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Expose the chest so you can [br]see where to place your hand.

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TIME 10:30

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Make sure your knees are [br]against the side of the chest.

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Place the heel of your hand [br]on the center of the chest

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in contact with the breastbone.

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Before we add pumping, [br]let's practice this again in real time.

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Sit back.

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Now, start the assessment.

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>[RESCUER] Hey! are you okay?

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>[NARRATOR] Have someone [br]call 9-1-1 and get an AED.

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>[RESCUER] [br]Drew! Call 9-1-1 and get the AED!!

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>[NARRATOR] Open the shirt [br]and position your hand to pump.

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Okay, in the next section, we'll put this [br]together with pumping and breathing.

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You're ready.

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You've practiced all the skills.[br]Now we'll put them together.

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Let's do CPR.

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Sit next to your mannequin.

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When you see a child who looks [br]unconscious, assess the child.

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>[RESCUER] Hey! Are you okay?

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>[NARRATOR] At the same time, [br]note if they are breathing or only gasping.

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Direct someone to call 9-1-1.

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>[RESCUER] [br]Drew! Call 9-1-1 and get the AED!

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>[NARRATOR] Expose the chest.[br]With your knees against the chest,[br]place your hand in position.

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Get ready. Pump.

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>[RESCUER] 1, 2, 3, 4, 5…

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>[NARRATOR] Each pump should [br]depress the chest about two inches ,

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then let it rise all the way back up

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but keep your hand in contact with the chest.

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>[RESCUER] …20, 21, 22, 23…

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>[NARRATOR] Get ready to breathe. [br]Each breath lasts one second.

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>[RESCUER] …28, 29, 30.

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>[NARRATOR] Give breaths.

9:59:59.000,9:59:59.000
One…

9:59:59.000,9:59:59.000
Two…

9:59:59.000,9:59:59.000
Arm straight. Pump.

9:59:59.000,9:59:59.000
>[RESCUER] 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, [br]11, 12, 13, 14, 15, 16, 17, 18, 19, 20,

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21, 22, 23, 24, 25, 26, 27, 28, 29, 30.

9:59:59.000,9:59:59.000
>[NARRATOR] Give breaths.

9:59:59.000,9:59:59.000
One…

9:59:59.000,9:59:59.000
Two…

9:59:59.000,9:59:59.000
Ready? Pump.

9:59:59.000,9:59:59.000
>[RESCUER] 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, [br]11, 12, 13, 14, 15, 16, 17, 18, 19, 20,

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21, 22, 23, 24, 25, 26, 27, 28, 29, 30.

9:59:59.000,9:59:59.000
>[NARRATOR] Breathe one…

9:59:59.000,9:59:59.000
breath two…

9:59:59.000,9:59:59.000
Position and pump.

9:59:59.000,9:59:59.000
>[RESCUER] 1, 2, 3, 4,[br]5, 6, 7, 8, 9, 10, 11…

9:59:59.000,9:59:59.000
>[NARRATOR] Keep up the pace. Count out loud.

9:59:59.000,9:59:59.000
>[RESCUER] 16, 17, 18, 19, 20, [br]21, 22, 23, 24, 25, 26, 27, 28, 29, 30.

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>[NARRATOR] Breathe.

9:59:59.000,9:59:59.000
Pump.

9:59:59.000,9:59:59.000
>[RESCUER] 1, 2, 3, 4, 5, 6, 7, 8, 9, 10,[br]11, 12, 13, 14, 15, 16, 17, 18, 19, 20,

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21, 22, 23, 24, 25, 26, 27, 28, 29, 30.

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>[NARRATOR] And breathe.

9:59:59.000,9:59:59.000
Sit back.

9:59:59.000,9:59:59.000
That was five cycles of pumping [br]and breathing. Good work.

9:59:59.000,9:59:59.000
When two or more rescuers are available,

9:59:59.000,9:59:59.000
alternating rescuers prevents a decrease [br]in quality of compressions

9:59:59.000,9:59:59.000
caused by rescuer fatigue.

9:59:59.000,9:59:59.000
After five cycles, you may switch[br]who is doing CPR.

9:59:59.000,9:59:59.000
>[RESCUER] 1, 2, 3, 4…

9:59:59.000,9:59:59.000
>[NARRATOR] When doing CPR on [br]an infant under the age of one,

9:59:59.000,9:59:59.000
there are a couple of key differences [br]in how the skills are performed.

9:59:59.000,9:59:59.000
Watch as our rescuer [br]demonstrates CPR for infants.

9:59:59.000,9:59:59.000
When she assesses the infant, [br]instead of tapping and shouting,

9:59:59.000,9:59:59.000
she stimulates the infant's foot [br]to check for response.

9:59:59.000,9:59:59.000
The response can be any vocal sound [br]like crying or cooing or a body movement.

9:59:59.000,9:59:59.000
At the same time, she assesses [br]whether the infant is breathing.

9:59:59.000,9:59:59.000
Once she determines that CPR is necessary,[br]she exposes the chest,

9:59:59.000,9:59:59.000
and instead of using the heel of her hand,

9:59:59.000,9:59:59.000
she positions two fingers [br]just below the nipple line.

9:59:59.000,9:59:59.000
She pumps at the same rate as for children,

9:59:59.000,9:59:59.000
but the depth is different.

9:59:59.000,9:59:59.000
The compression is 1/3 the depth of the chest

9:59:59.000,9:59:59.000
or about 1.5 inches.

9:59:59.000,9:59:59.000
>[RESCUER counting]

9:59:59.000,9:59:59.000
>[NARRATOR] After a cycle of compressions,

9:59:59.000,9:59:59.000
she tilts the head back and covers the mouth[br]and nose completely with her own mouth

9:59:59.000,9:59:59.000
and gives two breaths, [br]each lasting about 1 second.

9:59:59.000,9:59:59.000
The volume of air is enough [br]to make the chest rise.

9:59:59.000,9:59:59.000
If you are alone with an infant [br]or a child who needs CPR,

9:59:59.000,9:59:59.000
complete five cycles of pumping[br]and breathing before calling for help.