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What should I know about CPR during the COVID-19 pandemic? — COVID-19 stands for "coronavirus disease 2019." It is caused by a virus called SARS-CoV-2. The virus first appeared in late 2019 and has since spread throughout the world.
The virus can spread easily from person to person. This usually happens when a sick person coughs, sneezes, or talks near other people. One of the most important ways to slow the spread is to keep people away from each other. Because giving CPR involves touching another person, there is a risk of spreading the virus if either person is sick.
Expert groups have created some guidelines about giving CPR to someone who has, or might have, COVID-19. In areas where the virus has spread widely, these guidelines might be helpful, since you can't always tell if someone is sick. The main points are:
●If a child or infant's heart has stopped, another person should do chest compressions. They should also do rescue breathing ("mouth to mouth") if they are willing and able. This is explained more below.
●If possible, someone who lives in the same home as the victim should do CPR. That's because they have already been exposed to the person.
●If you do chest compressions on someone who does not live with you, and you cannot (or do not want to) do rescue breathing, use cloth to cover your mouth and nose if possible. You could also cover the victim's mouth and nose if cloth is easily available. This might help lower the risk of spreading the virus.
●People who are 65 years or older, or have other health problems (like heart disease, diabetes, lung disease, cancer, or obesity), are more likely to get very sick from COVID-19. If possible, it is better for someone without these risks to do CPR.
The rest of this article has general information about CPR for children.
What is CPR? — CPR stands for "cardiopulmonary resuscitation." It is a way to get blood and oxygen moving throughout the body of someone whose heart has stopped working.
CPR can save a person's life. It can keep the brain and other organs from being damaged by lack of oxygen. You do CPR until the heart can be shocked back into action or until it becomes clear the person cannot be saved.
The instructions for doing CPR on adults are different from the instructions for doing CPR on children and infants. This article is about doing CPR on children and infants. In this context:
●"Child" means any child who is 1 year old or older and who has not yet started puberty. (Puberty is the time in life when a child's body changes into the body of an adult. In girls, these changes typically start at about age 10 or 11. In boys, they typically start at about age 12 or 13.)
●"Infant" means any baby younger than 1 year.
What is an AED? — AED stands for "automated external defibrillator." It is a device that can tell if a person's heart needs to be shocked, and then give the shock. This can sometimes get a normal heart rhythm started again.
Many public places, such as shopping malls, airports, and sports events, have AEDs available. They come with directions so anyone can use them, even without special training. AEDs can save lives, since shocking a person's heart has the best chance of working when it is done right away.
Many AEDs come with special pads meant to be used for children or infants. These pads allow the device to give a smaller shock to the heart. But it is safe to use a regular AED on an infant or child if the pads are not available.
How do I know if a child or infant needs CPR? — If you see a child or infant who is passed out, tap them firmly and ask, "Are you OK?" If the child or infant does not respond to your voice or touch, is not breathing, or is breathing abnormally (gasping), call for an ambulance (in the US and Canada, dial 9-1-1).
If another person is nearby, tell them to get the AED while you start CPR. When you call for an ambulance, the person who answers the phone can tell you what to do. They will help you do CPR and tell you when you should use the AED. If you are calling with a cell phone, put the speaker on so you can have your hands free.
The person who needs CPR is often called the "victim." The person who does CPR is often called the "rescuer."
How do I do CPR? — You can do CPR even if you have never done it before and have never been trained. All you have to do is press hard and fast on the center of the victim's chest. You can still help if you're not sure how to do CPR.
Pressing on the chest for CPR is called doing "compressions." Compressions squeeze the victim's heart and get blood moving again.
If the victim is a child, you can do compressions using either the 2-hand or the 1-hand method. No matter how you do compressions, between compressions lift all pressure off the victim's chest, so that their chest goes back to where it was.
●2-hand method: First make sure the victim is on a flat, solid surface. Then kneel over the victim, stack your hands on top of one another with both palms facing down, and lock your fingers together. Holding your arms straight, press on the center of the victim's chest with the heel of your bottom hand (picture 1). Use your body weight, rather than the strength of your arms, to press on the chest. Make sure the victim's chest drops down at least 2 inches under your weight with each push.
●1-hand method: First make sure the victim is on a flat, solid surface. Then kneel over the victim, and place the heel of 1 hand on the center of the victim's chest. Holding your arm straight, press on the center of the victim's chest with the heel of your bottom hand (picture 2). Use your body weight, rather than the strength of your arm, to press on the chest. Make sure the victim's chest drops down at least 2 inches under your weight with each push.
If the victim is an infant, you can do compressions using either the 2-finger or the 2-thumb method.
●2-finger method: Lay the victim on a solid flat surface. Then put the fingertips of the index and middle fingers of 1 hand on the center of the infant's chest and start compressions (figure 1). Make sure their chest drops down at least 1½ inches under your pressure with each push.
●2-thumb method: Hold the victim with both hands, placing both thumbs on the center of the chest. Press both thumbs on the center of the infant's chest and start compressions (figure 2). Make sure their chest drops down at least 1½ inches under your pressure with each push.
What do I do besides compressions? — Follow 3 main steps, which are easy to remember based on the letters C-A-B:
●"C" stands for "Do chest compressions" – For this part, you do 30 compressions using 1 of the methods described above.
●"A" stands for "Check the airway" – For this part, you check the position of the victim's head and jaw to make sure the victim can breathe. If the victim's airway is closed, you can try moving the victim's head or opening their jaw to get the airway open.
●"B" stands for "Do rescue breathing" – For this part, you blow 2 breaths into to victim's mouth or mouth and nose. If the victim is a small child or an infant, you might need to form a seal over the victim's mouth and nose. If the victim is a larger child, you can instead pinch the victim's nose shut and breathe into their mouth. Rescue breathing gets some new air – with more oxygen – into the victim's lungs. After giving 2 breaths, you keep repeating the cycle – of 30 compressions and 2 rescue breaths – until an ambulance comes or someone else takes over.
Where can I go to learn more? — The American Heart Association (AHA) last updated the guidelines about how to do basic CPR for children in 2015. To learn more about CPR and find training centers in the United States or internationally, go to www.heart.org.
Patient education: Head injury in children and teens (The Basics)
Patient education: Sudden cardiac arrest (The Basics)
