Rescue Breaths for Kids: Techniques You Must Know

In emergency situations involving children, knowing how to properly administer rescue breaths can mean the difference between life and death. When a child is unresponsive and not breathing normally, immediate action is crucial. This guide provides essential information on performing rescue breaths for kids, ensuring you have the knowledge and confidence to act effectively in critical situations.

Understanding Rescue Breaths for Kids: The Basics

Rescue breaths, also known as mouth-to-mouth resuscitation, involve delivering oxygen to a child who is not breathing or not breathing adequately. Unlike adults, children’s cardiac arrests are often respiratory, making rescue breaths particularly important in pediatric emergencies.

Children have unique anatomical and physiological characteristics that require specific techniques different from those used for adults. Their airways are smaller, more flexible, and more easily obstructed. Additionally, their tongues are proportionally larger relative to their mouths, which can block the airway when unconscious.

Why Rescue Breaths for Kids Matter

In pediatric emergencies, respiratory issues frequently precede cardiac problems. Children may stop breathing due to various causes, including:

• Choking on foreign objects
• Drowning
• Severe asthma attacks
• Allergic reactions
• Respiratory infections
• Trauma or injury

When breathing stops, oxygen levels in the blood begin to drop immediately. The brain can only survive for approximately 4-6 minutes without oxygen before permanent damage occurs. Rescue breaths provide vital oxygen to the lungs and bloodstream, buying precious time until professional medical help arrives.

Rescue Breaths for Kids: Age-Specific Techniques

The techniques for administering rescue breaths vary slightly depending on the child’s age. For emergency response purposes, children are categorized into three groups:

1. Infants (under 1 year)
2. Children (1 year to puberty)
3. Adults (puberty and older)

This guide focuses on the first two categories.

Rescue Breaths for Kids: Infant Technique (Under 1 Year)

When an infant is unresponsive and not breathing normally, follow these steps:

1. Ensure safety: Make sure the environment is safe for both you and the infant.
2. Check responsiveness: Gently tap the infant’s feet and observe for any response.
3. Call for help: If alone, perform CPR for 2 minutes before calling emergency services (unless the collapse was sudden and witnessed, in which case, call immediately).
4. Position the infant: Place the infant on a firm, flat surface, supporting the head and neck in a neutral position. Avoid tilting the head too far back, as this can block the airway.
5. Open the airway: Gently tilt the head back slightly and lift the chin. This position helps to open the airway by moving the tongue away from the back of the throat.
6. Administer rescue breaths:
   • Cover the infant’s mouth and nose with your mouth, creating a seal.
   • Give 5 initial rescue breaths, each lasting about 1 second.
   • Watch for the chest to rise with each breath.
   • If the chest doesn’t rise, reposition the head and try again.
7. Continue with CPR: After the initial rescue breaths, begin chest compressions if there are no signs of life.

Rescue Breaths for Kids: Child Technique (1 Year to Puberty)

For children between 1 year and puberty:

1. Ensure safety: Check that the area is safe for you and the child.
2. Check responsiveness: Gently shake the child’s shoulders and ask loudly, “Are you okay?”
3. Call for help: If alone, perform CPR for 2 minutes before calling emergency services (unless the collapse was sudden and witnessed, in which case, call immediately).
4. Position the child: Place the child on a firm, flat surface.
5. Open the airway: Tilt the head back and lift the chin to open the airway.
6. Administer rescue breaths:
   • Pinch the child’s nose closed with your thumb and index finger.
   • Open your mouth, take a normal breath, and place your lips around the child’s mouth, creating a complete seal.
   • Give 5 initial rescue breaths, each lasting about 1 second.
   • Watch for the chest to rise with each breath.
   • If the chest doesn’t rise, reposition the head and try again.
7. Continue with CPR: After the initial rescue breaths, begin chest compressions if there are no signs of life.

Common Challenges with Rescue Breaths for Kids and How to Overcome Them

Even with proper training, administering rescue breaths to children can present challenges. Here are common issues and solutions:

1. Difficulty Creating a Seal

Problem: It can be challenging to create an effective seal over a child’s mouth, especially for infants.

Solution: For infants, cover both the mouth and nose with your mouth. For children, ensure you pinch the nose completely closed and create a tight seal around the mouth. If you’re having trouble, adjust your position or the child’s head position slightly.

2. Inadequate Breath Delivery

Problem: Breaths may be too forceful or too gentle.

Solution: For children, use the same force as a normal breath. For infants, use a gentler breath—just enough to see the chest rise. Remember that children’s lungs are smaller than adults’, so they require less air volume.

3. Gastric Inflation

Problem: Air may enter the stomach rather than the lungs, causing distention.

Solution: Avoid delivering breaths too forcefully. Ensure proper head position—too much tilt can lead to air entering the stomach. Give breaths slowly (about 1 second per breath) and only enough to make the chest rise.

4. Fear of Infection

Problem: Concerns about disease transmission may cause hesitation.

Solution: When available, use a barrier device such as a pocket mask or face shield. However, in an emergency situation where equipment is unavailable, the benefits of providing rescue breaths generally outweigh the risks, especially for children.

Integrating Rescue Breaths for Kids into Full CPR

Rescue breaths are just one component of pediatric CPR. For a child who is unresponsive and not breathing normally, full CPR involves a combination of chest compressions and rescue breaths.

The current recommended ratio for laypeople performing CPR on children is:

• 30 chest compressions followed by 2 rescue breaths
• Continue this cycle until emergency services arrive or the child shows signs of life

For healthcare providers or those with advanced training, the ratio is:

• 15 chest compressions followed by 2 rescue breaths when two rescuers are present
• 30 chest compressions followed by 2 rescue breaths for single-rescuer CPR

Remember these key differences in pediatric CPR compared to adult CPR:

• Use less force for chest compressions
• Compress the chest approximately one-third of the depth of the chest
• For infants, use two fingers or two thumbs for compressions
• For children, use one or two hands, depending on the child’s size

Special Circumstances for Rescue Breaths for Kids

Drowning Victims

For children who have experienced drowning, rescue breaths are particularly crucial. In these cases:

• Start with 5 initial rescue breaths before beginning chest compressions
• Continue with standard CPR ratio (30:2 for laypeople, 15:2 for healthcare providers with two rescuers)
• Do not attempt to drain water from the lungs before beginning rescue breaths—this wastes valuable time

Trauma Victims

For children with suspected spinal injuries:

• Minimize head movement
• Use the jaw-thrust method to open the airway instead of head-tilt/chin-lift
• Maintain manual stabilization of the head and neck throughout

Children with Tracheostomy

Some children have tracheostomy tubes. If you need to give rescue breaths to a child with a tracheostomy:

• Remove any attachments from the tube
• Create a seal around the tracheostomy tube opening
• Give breaths directly into the tube
• Watch for chest rise to confirm effective ventilation

Importance of Formal Training in Rescue Breaths for Kids

While reading about techniques is helpful, there is no substitute for hands-on training. Formal training provides:

• Practice on mannequins of different sizes
• Feedback on technique from qualified instructors
• Confidence in performing skills under pressure
• Up-to-date information on current guidelines
• Opportunity to ask questions and address concerns

Prevention and Preparation: Beyond Rescue Breaths for Kids

Prevention is always preferable to emergency response. To prevent situations where rescue breaths might be needed:

1. Childproof your home: Remove choking hazards and secure dangerous areas.
2. Never leave children unattended around water: This includes bathtubs, pools, and natural bodies of water.
3. Learn to recognize signs of respiratory distress: Intervening early can prevent complete respiratory failure.
4. Keep emergency numbers readily available: Program emergency contacts into your phone and post them in visible locations.
5. Create an emergency action plan: Ensure all caregivers know what to do in an emergency.

What to Do After Performing Rescue Breaths for Kids

After an emergency where you’ve performed rescue breaths:

1. Debrief with emergency responders: Provide detailed information about what happened and what actions you took.
2. Seek medical follow-up: Even if the child appears to recover completely, medical evaluation is essential.
3. Address emotional impacts: Both the child and the rescuer may experience emotional reactions following a traumatic event. Consider professional support if needed.
4. Review and reflect: Consider what went well and what could be improved for future reference.
5. Refresh your training: Use the experience as motivation to maintain current CPR and first aid skills.

Take Action Today: Learn Rescue Breaths for Kids and More

Knowing how to perform rescue breaths for kids is a vital skill that every parent, teacher, caregiver, and responsible adult should possess. However, reading about these techniques is just the first step. To truly master these lifesaving skills and gain confidence in emergencies, professional training is essential.

Get Certified Today

CPR Cincinnati offers comprehensive training in pediatric CPR and first aid, including proper rescue breathing techniques for children of all ages. As an American Heart Association training site, we provide BLS certification Cincinnati courses for healthcare providers and CPR certification Cincinnati classes for parents, teachers, and caregivers. Our training includes hands-on practice with expert instructors in a stress-free learning environment with convenient scheduling options. Don’t wait until an emergency happens to wish you knew what to do. Contact CPR Cincinnati today to schedule your training and gain the confidence and skills to save a child’s life when it matters most.

Remember, in an emergency involving a child, the most important factors are recognizing the problem quickly, calling for help, and taking immediate action. With proper training in rescue breaths for kids and CPR, you can be prepared to provide vital care until professional help arrives.