Pediatric Rescue Breathing: A Comprehensive Guide

1. Understanding Pediatric Rescue Breathing

Pediatric rescue breathing is a life-saving technique used when a child or infant has a pulse but is not breathing normally. This differs from CPR because chest compressions are not required unless the heart stops. Rescue breathing supplies oxygen to the lungs, preventing brain damage and cardiac arrest.

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2. When to Perform Pediatric Rescue Breathing

Rescue breathing is required when:

• The child/infant has a pulse but is not breathing normally (e.g., gasping or not breathing at all).
• The child/infant is in respiratory failure (slow, irregular, or weak breathing).
• The child/infant has experienced drowning, choking, or overdose but still has a heartbeat.

How to Check for Signs of Breathing and Pulse

1. Look for chest rise and fall.
2. Listen for breath sounds near the nose and mouth.
3. Feel for air movement on your cheek.
4. Check the pulse:
   • Children (1 year – puberty): Check the carotid artery (neck).
   • Infants (under 1 year): Check the brachial artery (inside upper arm).

• If there is a pulse but no breathing, begin rescue breathing.
• If there is no pulse and no breathing, start CPR.

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3. Pediatric Rescue Breathing Guidelines (Based on AHA 2020)

Age Group	Breaths per Minute	Ventilation Method	Breath Duration
Infant (0-12 months)	1 breath every 3-5 seconds (12-20 breaths per minute)	Mouth-to-mouth-and-nose or bag-mask ventilation	1 second per breath
Child (1 year to puberty)	1 breath every 3-5 seconds (12-20 breaths per minute)	Mouth-to-mouth or bag-mask ventilation	1 second per breath

• Reassess pulse every 2 minutes.
• If pulse drops below 60 bpm with signs of poor circulation, begin CPR.

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4. Step-by-Step Guide for Pediatric Rescue Breathing

A. Infant Rescue Breathing (0-12 Months)

1. Check responsiveness – Tap the infant’s foot and shout their name.
2. Open the airway – Use the neutral sniffing position:
   • Slightly tilt the head back.
   • Lift the chin gently.
   • Avoid overextending the neck.
3. Check for breathing & pulse:
   • Look, listen, and feel for no more than 10 seconds.
   • Check the brachial pulse (inside the upper arm).
4. Give rescue breaths:
   • Seal your mouth over both the infant’s nose and mouth.
   • Give one breath every 3-5 seconds.
   • Each breath should be gentle and just enough to make the chest rise.
5. Monitor chest rise:
   • If the chest does not rise, reposition the head and try again.
6. Continue rescue breathing:
   • Check pulse every 2 minutes.
   • If the pulse drops below 60 bpm with signs of poor perfusion, begin CPR.

B. Child Rescue Breathing (1 Year to Puberty)

1. Check responsiveness – Tap the child’s shoulder and shout their name.
2. Open the airway – Use the head-tilt, chin-lift maneuver.
3. Check for breathing & pulse:
   • Look, listen, and feel for no more than 10 seconds.
   • Check the carotid pulse (side of the neck).
4. Give rescue breaths:
   • Seal your mouth over the child’s mouth.
   • Pinch the nose closed.
   • Deliver one breath every 3-5 seconds.
   • Each breath should last 1 second and make the chest rise.
5. Monitor chest rise:
   • If the chest does not rise, reposition the head and try again.
6. Continue rescue breathing:
   • Reassess pulse every 2 minutes.
   • If the pulse drops below 60 bpm, start CPR.

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5. Special Considerations

A. If the Chest Does Not Rise

• Check for airway blockage (tongue, secretions, food, or foreign objects).
• Reposition the airway and try again.
• If there is an obstruction, perform:
  • Infant back slaps and chest thrusts.
  • Child abdominal thrusts (Heimlich maneuver).

B. Using a Bag-Mask Device (BVM)

• Used by trained professionals (EMTs, paramedics, healthcare providers).
• Attach oxygen if available.
• Ensure a tight mask seal and proper ventilation.

C. Oxygen Use

• If oxygen is available and trained responders are present, administer oxygen via a non-rebreather mask or nasal cannula to support breathing.

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6. When to Stop Rescue Breathing

• The child or infant begins breathing normally on their own.
• Medical professionals take over.
• The rescuer is too exhausted to continue.
• The patient loses their pulse – Begin CPR immediately.

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7. Common Mistakes to Avoid

❌ Giving too much air – Can cause stomach inflation and vomiting.
❌ Not repositioning the head if the chest does not rise.
❌ Failing to check the pulse every 2 minutes – Could delay needed CPR.
❌ Over-ventilating – Breaths should be gentle and just enough to see chest rise.

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8. Summary of Key Steps

1. Assess responsiveness (tap and shout).
2. Check breathing & pulse (10 seconds max).
3. Open the airway (head-tilt, chin-lift for children; neutral position for infants).
4. Give one breath every 3-5 seconds (chest rise).
5. Reassess pulse every 2 minutes.
6. If pulse <60 bpm, begin CPR.

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Final Thoughts

Pediatric rescue breathing is critical in preventing cardiac arrest in children and infants experiencing respiratory failure. Knowing when and how to perform it correctly can mean the difference between life and death.

Would you like a training guide or visual chart for your CPR business on pediatric rescue breathing?