When every second matters: how CPR can save a child’s life

No parent expects to face the moment when their child’s heart stops beating. But when it happens, acting quickly can make all the difference.

One of the most important skills parents and caregivers can have is knowing how to perform cardiopulmonary resuscitation (CPR), particularly for children with heart conditions.

Dr Soo Kok Wai, consultant paediatric cardiologist at Institut Jantung Negara (IJN), spoke with FMT Lifestyle about recognising the warning signs of cardiac arrest, and what parents and caregivers should know about performing CPR.

“Children with congenital heart disease are at a higher risk. Their hearts do not have the same reserve as healthy children, so they can go into cardiac arrest more easily,” said Soo.

In other words, their hearts have less capacity to cope with increased physical stress. Higher-risk groups include children born with a single ventricle, severe left heart obstruction, or cyanotic heart disease aka “blue baby syndrome”.

Children with abnormal heart rhythms and those recovering from heart procedures are also more vulnerable, especially during the first three months after surgery.

The Paediatric Assessment Triangle can help parents and caregivers recognise warning signs of cardiac arrest. Look out for:

• changes in the child’s appearance, such as becoming limp and unresponsive;
• breathing that is shallow or rapid; and
• skin that appears pale, grey or blue.

Dr Pan Kok Onn, a paediatric advanced life support instructor at IJN, demonstrated the steps for performing CPR on a child:

• Step 1: Check your surroundings to make sure there is no danger.
• Step 2: Check for a response. If there is none, check for breathing and circulation. If there are no signs of either, begin CPR.
• Step 3: Place your hands in the centre of the chest between the nipple line.
• Step 4: Perform 30 chest compressions followed by two rescue breaths.
• Step 5: Push hard to one-third of the chest depth at a rate of 100-120 compressions per minute.
• Step 6: Allow the chest to recoil fully and keep interruptions to a minimum.
• Step 7: Repeat the cycle of 30 chest compressions and two rescue breaths.
• Step 8: Make sure the chest rises with each breath, then continue CPR.
• Step 9: Continue for five cycles, or about two minutes, before checking again for breathing and circulation.

According to Soo, pauses during CPR should be kept to a minimum as they reduce the pressure needed to restart the heart.

Parents and caregivers, he added, should not hesitate to perform CPR. A child’s ribcage is flexible, so the risk of serious injury is low, and the standard hand placement is suitable even for children with complex heart conditions.

Although the principles remain the same, the way CPR is performed differs depending on the child’s age.

For infants, rescuers should use the two-thumb encircling technique, with both thumbs placed on the centre of the chest while supporting the infant’s back with both hands.

For toddlers, CPR is performed using a single-palm technique, placing the heel of one hand in the centre of the chest.

If a child goes into cardiac arrest and you are the only person present, remain calm and start CPR immediately. Continue for two minutes while shouting for help.

If nobody responds, call an ambulance on speakerphone and continue CPR until help arrives.

“Your hands and breath are the child’s temporary heart and lungs. By performing good CPR, pushing hard and fast, you can save a life,” Soo concluded.

Interested in learning CPR? IJN’s CPR Faculty offers training sessions for groups of 10 or more. For more information, call 03-2617 8200 or email [email protected].

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