Okay, now in this training segment, we're going to talk about what to do when your conscious
choking infant has gone unresponsive. Now, if you've not already activated EMS by calling
911, or calling the code, now is your opportunity to do so. If you don't have a cellphone available,
or you don't have a runner to go call 911, or there is not a code button, you're gonna
have to do it yourself. I like to bring the baby with me, so that I have them available
either to do CPR in route or I have them, so that once I have activated EMS, they are
right there with me, so I can begin my compressions again. However, after we've told somebody
you in a plaid shirt, go call 911, come back I might need your help, and bring in AED if
you can find one. Now, we're going to actually go right into chest compressions. The reason
we're doing that is because we're already with the baby when conscious choking. If you
were with the baby you might need to start with the reassessment. But, we're gonna say
we're continuing on, baby was conscious, they were chocking, now they're unconscious, and
they're still choking. Nipple line for the landmark, two fingers down at the lower third
of the sternum, third the depth of the chest at 100-120 compressions per minute. We're
gonna start right now. One, and two, and three, and four, and five, and six, and seven, and
eight, nine, ten, eleven, twelve, thirteen, fourteen, fifteen, sixteen, seventeen, eighteen,
nineteen, twenty, twenty-two, twenty-three, twenty-four, twenty-five, twenty-six, twenty-
seven, twenty-eight, twenty-nine, thirty. I bring the baby's head into a neutral position,
and look in the mouth and see if there is a product, if I don't see product, I am not
going in verse a blind finger sweep, that's contraindicated in babies. I don't see anything
visibly, so I am gonna go ahead and attempt rescue breath. Nothing goes in, so I re-position
ahead and try again, nothing goes in. So, I am gonna go right back into my thirty chest
compressions. After my thirty chest compressions, I re-look into the mouth, and look for an
object, but I do see it now, so I am going to sweep it out with my smallest finger I
have, my pinkie, I go in with a hooking motion, and try to sweep it out. After the object
is clear, I reseal my rescue mask and try another rescue breath. The chest rose and
fell, and I get a second rescue breath. Now, as a health care provider, I check a break
your pulse for no more than 10 seconds. Now, in infants, if their heart rate is lower than
60 beats per minute, it's indicated that we override the chest compressions in CPR. But if we're
not supposed to check a pulse for more than 10 seconds, how do we know that it's only 60
beats per minute? You can multiply it times 6, when you check it for 10 seconds. So for
instance, a baby who's been in distress now breathing is probably gonna be a bit tachycardiac.
Now remember, infants can range on a high end between 120 to 180 beats per minute,
depending on their age. So, it's not going to be abnormal to feel a really fast and maybe
even a slightly thready pulse. What we call thready is thin like it's getting weaker, and
I check for 10 seconds, and it's 30 beats in that 10 seconds. I am watching my watch, I
check it for 10 seconds, and it came to 30. 30 times 6 is 180 beats per minute. So,
we've got plenty of heart contractions going on in a great rate, but the baby's not breathing
normally. So, I am gonna go right back into my rescue breaths. Rescue breaths without
compressions is once every three seconds for two minutes. After approximately two minutes,
I am gonna reassess for a bronchial pulse, and if the pulse is gone, and the baby's not
breathing, I go right into the full CPR, 30 compressions, two rescue breaths, and I am
gonna do that until help arrives, until an AED arrives, or until the baby revives.