Mouth-to-mouth resuscitation in children

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

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Mouth-to-mouth resuscitation is needed if a child stops breathing. The first aider blows the breath in the child. This gives it enough oxygen until the rescue workers arrive. The basic principle of mouth-to-mouth resuscitation in children is the same as in adults. There are a few differences, however. Read here what they are and how to properly ventilate a baby or child.

Brief overview: mouth-to-mouth resuscitation in children

• What is mouth-to-mouth resuscitation? A first aid measure in which a first aider blows the exhaled air into an unconscious person when he is no longer breathing independently.
• Procedure: Lay the child flat on its back, put the head in a normal position in babies, and slightly back the neck in older children. Now breathe in and tightly enclose the child's open mouth or the baby's mouth and nose with your own mouth. Then carefully and evenly blow air into the child's lungs for about a second.
• In what cases? When the baby or child no longer breathes independently and / or has cardiovascular arrest.
• Risks: If air accidentally gets into the child's stomach, it can lead to vomiting. During the next breath, the contents of the stomach can then get into the lungs.

Caution!

• Even if you are afraid of a lifeless child - do not pull it up or shake it! You could hurt the child (worse).
• Often, especially in small children, foreign bodies that are swallowed or inhaled block the airways. Before ventilating, look into the mouth / throat and nose and remove all foreign bodies!
• In babies, the head must not be overstretched backwards. This could narrow the airways and allow the air you exhale to enter the baby's stomach instead of the baby's lungs.
• Start with five breaths. If the child still does not breathe again afterwards, start the cardiac massage immediately! Another two seconds each, after five shocks the pulse is checked.
• Children's lungs are very small! A “mouthful” is sufficient for infants and a maximum of a quarter of the exhaled air for older children.

How does mouth-to-mouth resuscitation work in children?

Before starting the resuscitation, test the child's awareness by speaking to them, touching them, pinching them lightly, or gently shaking them. If the child is unconscious and not breathing, you should start resuscitation immediately.

Breathing donation in infants and young children

Children up to the end of the first year of life are referred to as infants. Children in the 2nd and 3rd year of life are called toddlers.

1. For resuscitation, the child should lie flat on their back, preferably on a hard surface such as the floor.
2. The baby's head should be in a neutral position (do not overstretch!). Since the head is usually slightly bent forward in a supine baby, for a neutral position it is necessary to lift the chin slightly without bending the neck backwards. With a toddler, the head can easily be overstretched.
3. Inhale just before you put your mouth open around the child's mouth and nose.
4. Blow some air into the infant using little pressure for 1 to 1.5 seconds. A “mouthful” is sufficient for babies and a little more for small children. The child's chest must rise during ventilation.
5. Release the child's mouth again and watch to see if the chest sinks again. Then donate the next breath!
6. If the child's chest does not rise during the resuscitation or if you need a lot of pressure to get air in, check to see if there is a foreign body or vomit in the airway. If so, you need to remove it.
7. First, make five such breath donations. Then try to feel the child's pulse and see if the child is already starting to breathe by itself.
8. If you cannot find any further signs of life (pulse, breathing, spontaneous movements, cough), you must immediately start with the cardiac pressure massage, which you then alternate with the donation of breath. A rhythm of 30: 2 is recommended (i.e. 30 x heart pressure massage and 2 x breath donation alternately).
9. Continue resuscitation until the child breathes on their own again or the emergency doctor arrives.

Resuscitation in older children

1. In children from the age of 3, the head is slightly overstretched for mouth-to-mouth resuscitation in order to open the airways. To do this, take hold of the child's head by the chin and forehead and carefully tuck it back a little.
2. Close the child's nose with your thumb and forefinger.
3. Breathe in normally, place your mouth airtight over the child's.
4. Blow air into the child's lungs for 1 to 1.5 seconds (not too much - one breath from an adult is about four children's breaths). The child's chest must rise visibly during the resuscitation.
5. Release the child's mouth again and watch to see if the chest sinks again. Then donate the next breath!
6. First, make five such breath donations. Then try to feel the child's pulse and see if the child is already starting to breathe by itself.
7. If you cannot find any further signs of life (pulse, breathing, spontaneous movements, cough), you must immediately start with the cardiac pressure massage, which you then alternate with the donation of breath. A rhythm of 30: 2 is recommended (i.e. 30 x heart pressure massage and 2 x breath donation alternately).
8. Continue resuscitation until the child breathes on their own again or the emergency doctor arrives.

When do I give mouth-to-mouth resuscitation to the child?

A child needs to be given a breath if it is no longer able to breathe independently. If the cause is a foreign body in the airways, you have to remove it with your finger, tapping on the back or using the Heimlich handle, if possible. Often the child is breathing again by itself. If not, start mouth-to-mouth resuscitation.

Risks of resuscitation in children

The anatomy of the airways differs slightly from that of adults, especially in very young children. Therefore, you should not over-stretch your head in an infant (children up to one year old), as this would narrow the delicate airways. The respiratory donation would then not succeed or not be sufficient.

Breathing in infants is mainly through the diaphragm. If the first aider is ventilating with too much pressure, the stomach can inflate and press on the diaphragm, preventing the lungs from expanding. There is also the risk that the infant will vomit due to the overinflation of the stomach and that the vomit will obstruct the airways. Last but not least, too much pressure when blowing in can injure a child's lungs.

Despite these potential risks, in an emergency, do not hesitate to breath your breath to a child who is no longer breathing. A person only survives a respiratory arrest for a few minutes. Therefore, rapid mouth-to-mouth resuscitation can save a child's life!

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