How to perform CPR for a child with a tracheostomyHHow to perform CPR for a child with a tracheostomyHow to perform CPR for a child with a tracheostomyEnglishRespiratoryChild (0-12 years);Teen (13-18 years)Lungs;TracheaRespiratory systemNon-drug treatmentCaregivers Adult (19+) Hospital healthcare providersNA2017-06-29T04:00:00ZReshma Amin, MD, FRCPC, MSc;Faiza Syed, BHSc, RRT;Tuyen Tran, RRT000Flat ContentHealth A-Z

 

 

How to perform CPR for a child with a tracheostomy2949.00000000000How to perform CPR for a child with a tracheostomyHow to perform CPR for a child with a tracheostomyHEnglishRespiratoryChild (0-12 years);Teen (13-18 years)Lungs;TracheaRespiratory systemNon-drug treatmentCaregivers Adult (19+) Hospital healthcare providersNA2017-06-29T04:00:00ZReshma Amin, MD, FRCPC, MSc;Faiza Syed, BHSc, RRT;Tuyen Tran, RRT000Flat ContentHealth A-Z<p>The table below has instructions on performing CPR for an infant, child or teen with a tracheostomy.</p><p></p><div class="caution"><h3>Important!</h3><p>The instructions below are not intended to replace hands-on CPR training from your child’s healthcare team.</p></div><p></p><h2>How to perform CPR when a child has a tracheostomy</h2><table class="akh-table"><thead><tr><th></th><th>Teen</th><th>Child</th><th>Infant</th></tr></thead><tbody><tr><td>1. Secure the scene</td><td colspan="3"> Make sure the immediate environment is safe.</td></tr><tr><td>2. Check person</td><td><p>Check breathing and pulse rate for responsiveness. Signs that a person is unresponsive include:</p><ul><li>no breathing or only gasping</li><li>no definite pulse within 10 seconds.</li></ul></td><td></td></tr><tr><td>3. Call 911</td><td>If alone, call 911.</td><td colspan="2">If alone, start CPR (see step 4) before calling for help.</td></tr><tr><td></td><td colspan="3"><ul><li>If you are alone without a cell phone and did not see the onset of the breathing emergency, do two minutes of CPR before getting help.</li><li>If someone is with you, have them call 911. Ask them to tell you when that is done.</li></ul></td></tr><tr><td>4. Start chest compressions</td><td colspan="3"><ul><li>Start doing 30 chest compressions, followed by two breaths (see below). Repeat at a rate of 100-120 compressions a minute.</li><li>If there is another person with you, take turns following the 30:2 ratio of compressions to breaths. Once you perform two minutes of CPR (chest compressions and breaths), have the second person perform CPR for two minutes.</li><li>Continue switching roles every two minutes, or switch sooner if one of you is too tired to continue chest compressions.</li></ul></td></tr><tr><td>5. Give breaths</td><td colspan="3"><ul><li>Position the airway. Tilt head, lift chin and uncover the tracheostomy tube. </li><li>Make sure the tracheostomy tube is open and the airway is in place. </li><li>Use the manual resuscitation bag to give <strong>two breaths</strong> into the tracheostomy tube as you were taught. Give just enough air volume to make the chest rise.</li><ul><li>​If the chest does not rise with a manual breath, suction before trying two breaths again.</li><li>If there is no chest rise, change the tracheostomy tube before trying two breaths again. </li><li>If you cannot replace the tracheostomy tube, give ventilation through the mouth and nose, as with regular CPR.​</li></ul></ul></td></tr><tr><td>6. Continue CPR</td><td><ul><li>Give CPR in 30:20 ratio (alternating 30 compressions and two breaths).</li><li>Continue until medics arrive with an AED (automated external defibrillator).</li></ul></td><td colspan="2"><ul><li>Keep CPR going for two minutes. This is five cycles of 30:2 (30 compressions and two breaths).</li><li>Stop CPR after two minutes to call 911, if not already called.</li><li>Resume CPR until medics arrive or child/infant responds.</li></ul></td></tr><tr><td>7. When to stop CPR </td><td colspan="3"><ul><li>Stop chest compressions when your child's heart rate is at least 60 beats per minute.</li><li>Continue to suport breaths with manual resuscitation bag if needed.</li></ul></td></tr></tbody></table><h2>How do I ventilate my child if I cannot replace their tracheostomy tube during CPR?</h2><p>If your child’s chest does not rise after you suction or change their tracheostomy tube, you will need to remove your child’s tracheostomy tube and perform manual ventilation along with the chest compressions.</p><h3>Performing manual ventilation and CPR</h3><ul><li>Attach a face mask to the manual resuscitation bag.</li><li>Tilt your child’s head back so that their chin is slightly lifted.</li><li>Apply the mask to your child’s mouth and nose and hold it tightly to achieve a tight seal.</li><li>If there is another person with you, have them cover your child’s stoma while you give two breaths through the face mask. If you are alone, cover the stoma with your thumb while giving the two breaths through the face mask.</li><li>Continue CPR, giving 30 chest compressions followed by two breaths with the manual resuscitation bag.<br></li></ul><p></p> <a class="btn btn-primary" href="https://www.aboutkidshealth.ca/trachvent">Return to trach-vent learning hub</a><br>How to perform CPR for a child with a tracheostomyTruehttps://www.aboutkidshealth.ca/Article?contentid=2950&language=Englishhttps://www.aboutkidshealth.ca/Article?contentid=2948&language=English

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