You are alone and caring for a 9-month-old infant with an obstructed airway who becomes unresponsive. Which action should you perform first?
The correct answer and explanation is :
Correct Answer:
Perform 5 back slaps and 5 chest thrusts while checking for airway obstruction. If the infant becomes unresponsive, immediately begin CPR with chest compressions and rescue breaths and check for a foreign object before giving breaths.
Explanation:
When a 9-month-old infant has an obstructed airway and becomes unresponsive, immediate action is required to prevent severe hypoxia and cardiac arrest.
- Confirm Unresponsiveness:
- If the infant is not breathing and unresponsive, shout for help and call 911 or emergency services if possible.
- Initiate CPR Immediately:
- Place the infant on a firm, flat surface and begin chest compressions at a rate of 30 compressions to 2 breaths (if alone, otherwise 15:2 if two rescuers are available).
- Use two fingers placed just below the nipple line and push 1.5 inches deep at a rate of 100-120 compressions per minute.
- Check for Airway Obstruction:
- After 30 compressions, open the infant’s mouth and look for a visible object.
- If a foreign body is seen, carefully remove it without blind finger sweeps.
- Give Rescue Breaths:
- Tilt the infant’s head slightly back, create a seal over the nose and mouth, and deliver two small breaths (each lasting about 1 second).
- Observe for chest rise. If the chest doesn’t rise, reposition the head and try again.
- Repeat CPR Cycles Until Help Arrives:
- Continue compressions and rescue breaths until emergency services arrive or the infant shows signs of life.
Do Not Perform Abdominal Thrusts (Heimlich Maneuver) on an infant, as this can cause internal injury. The priority is maintaining circulation through CPR while trying to clear the airway.
Illustration:
Here is an illustration demonstrating the proper steps for performing infant CPR on an unresponsive baby with an obstructed airway.