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Appropriate CPR techniques for carers of infants outside of hospital
  1. Rachael K Gregson1,2,
  2. Mark J Peters1,2
  1. 1 Respiratory, Critical Care and Anaesthesia Section in Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London, UK
  2. 2 Paediatric and Neonatal Intensive Care, Great Ormond Street Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Rachael K Gregson, Respiratory, Critical Care and Anaesthesia section in Infection, Immunity and Inflammation Program, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK; r.gregson{at}ucl.ac.uk

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Sudden out-of-hospital cardiac arrest with unsuccessful cardiopulmonary resuscitation (CPR) is the third leading cause of death in industrialised nations. Up to 70% of out-of-hospital cardiac arrests are witnessed by family members, friends and other bystanders. A greater percentage of cardiac arrests in infants are likely to involve first responders who are the child’s family members or other close caregivers. There is considerable rescuer variation in compression treatment styles, as shown in figure 1.1 When compared with adults, relatively few CPR data exist regarding treatment of children during cardiac arrest. As a result, internationally agreed CPR guidelines have been developed with data often extrapolated from adults or animal studies.2

Figure 1

Variation in compression profiles of two health professionals treating the same young child during cardiac arrest. cpm, compressions per minute.

Evidence suggests people feel unprepared for resuscitation of young children, babies and infants. Outcomes of infant CPR remain poor. This is partially due to the aetiology of the arrest, with hypoxia being much more common than primary arrhythmia. However, poor-quality chest compressions probably contribute to low return of spontaneous circulation rates. Training in CPR is believed to enhance real-life performance. Much effort is being expended to ‘upskill’ the general public in CPR, facilitating both competence and confidence. These include global initiatives such as the ‘World Restart a Heart Day’ and ‘Kids …

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