WHAT YOU NEED TO KNOW:

What is lay person CPR on newborns? Lay person cardiopulmonary resuscitation (CPR) is an emergency procedure for a newborn who is up to 1 month old. A lay person is someone who is not a trained healthcare worker. A newborn will usually need CPR because he stopped breathing. He may need CPR because his heart stopped beating. This may be due to an accident, injury, or medical condition. CPR combines chest compressions with rescue breathing. A chest compression is when you put pressure on and off the newborn's chest. Rescue breathing means you give breaths to the newborn through his mouth and nose.

What should I do if I find a newborn who is not breathing normally?

• Call 911 immediately, or send someone to call for help. Call 911 before you start CPR. The faster help arrives, the greater the chance the newborn will live. Stay on the telephone with the 911 operator until he tells you to hang up.
  
  
• Make sure the area is safe to enter, and approach the newborn. Move him only if the area is dangerous, such as in a fire.
  
  
• Kneel beside him. Look to see if his head, neck, or back may be hurt. Carefully turn him onto his back while you support his head and neck. Keep the newborn's body straight as you turn him onto his back.
  
  
• Begin CPR if the newborn is not breathing or is only gasping. Continue CPR until he responds, help arrives, or an automated external defibrillator (AED) becomes available. An AED is a device that gives a person's heart a shock if it is needed. AEDs are often kept in public areas and are usually mounted to a wall.

How do I give CPR to a newborn? Learn the steps used to give CPR to newborns by remembering A-B-C: Airway, Breathing, and Chest compressions. Open the newborn's airway. Hold the airway open and give 1 rescue breath. Then do 3 chest compressions. Repeat a pattern of 1 rescue breath and 3 chest compressions until the newborn responds, help arrives, or an AED is available.

How do I open a newborn's airway?

• Put 1 hand on the newborn's forehead and press firmly backward to tilt his head back. Do not place your hand on the back of his neck to tilt his head.
  
  
• Lift the newborn's chin with your other hand. Hold his mouth open. Do not press deeply into the soft tissue under his chin, because this can close his airway.
  
  
• Look into the newborn's mouth for something that may be blocking his airway at the back of his throat. Examples are food and small toys. If you see something that looks easy to get, carefully scoop it out with your finger.

How do I give rescue breaths?

• Take a deep breath and put your lips around the newborn's nose and mouth, making an airtight seal. If your mouth is too small to cover both the newborn's mouth and nose, pinch his nose closed and cover his mouth with yours. You may also try giving breaths through the newborn's nose only while you hold his mouth closed.
  
  
• Give 1 breath (1 second for each breath) into the newborn. Do not give large breaths. Do not breathe hard or fast. Take a normal breath for yourself after each breath that you give.
  
  
• The newborn's chest will rise each time you give a rescue breath if his airway is open. You may need to change his head position to reopen his airway. If you still cannot get air in, the airway may be blocked by an object. Look again to see if you find an object you can remove.

How do I give chest compressions? Chest compressions press the heart between the spine and sternum (breastbone). This forces blood out of the heart and to the newborn's brain and body.

• Stand facing the newborn. Put the pads of your 2 thumbs where the newborn's ribs meet in the middle of his chest, between the nipples. This area is called the sternum.
  
  
• With the pads of your thumbs, press down on the newborn's sternum 1½ inches (4 centimeters). This should be at least ⅓ the depth of the newborn's chest.
  
  
• Do not push your hands forward when you press down. Go only up and down. The compressions should be constant and equal. This means that it should take the same amount of time to press down as it does to come back up. Allow the chest to relax completely between compressions. This allows blood to come back into the heart before you compress again. Leave your thumbs on the newborn's chest in the correct hand position between compressions.
  
  
• Do 3 chest compressions. Push hard and push fast. Do not delay or stop the compressions. Count the compressions out loud to help you do them at a steady, even speed. Fast, steady compressions increase the chance that the newborn will live.

How do I use an AED? The following are general directions for AED use. Follow the step-by-step directions that may be found on or inside the AED. Do not remove an AED from its storage case unless you intend to use it. Remove all clothing from the newborn's chest before you open the AED.

• Open the AED: There may be a latch on one or both sides of the device to open it.
  
  
• Find the electrode pads: You may need to pull a handle or open or unwrap the pads. The pads may be attached to the device by thin wires. Do not detach the pads from the device.
  
  
• Prepare the pads: Electrode pads may have a sticky side that sticks to the newborn's chest. You may need to remove paper backing from the pads to expose the sticky side before they can be used.
  
  
• Prepare the newborn: Move the newborn out of water if needed. Wipe any water or blood off his chest. The skin must be dry before you apply the pads.
  
  
• Apply the pads: Place one pad on either the left or right side of the upper chest, toward the middle and below the clavicle (collarbone). Place the other pad on the opposite side, just below and to the side of the breast. You may also place each pad on each side of the ribcage, just below and to the outside of the breasts. The AED will then give a shock if needed.
  
  
• Turn on the AED. The on button or switch should be clearly marked. The AED will tell you what to do next. If the AED tells you to shock, press the flashing red light. Do not touch the newborn when the AED analyzes or delivers a shock. If no shock should be given, the AED will tell you to continue CPR.
  
  
• Begin CPR: After a shock is given, the newborn's heart may take a minute or more to begin beating correctly. Because of this, start doing CPR again immediately. Give 1 rescue breath followed by 3 chest compressions until the newborn responds or help arrives.

What can I do to help prevent respiratory and cardiac arrest in newborns?

• Do not leave your newborn alone in or near water, such as a pool or bathtub.
  
  
• Keep your newborn secured in a car safety seat. Never leave your newborn in a car alone. Do not drive if you have been drinking alcohol, or if you have taken drugs or medicines that make you sleepy.
  
  
• Lay your newborn on his back when you put him down to sleep. He may be at more risk of SIDS if he sleeps on his stomach or on a soft surface. Do not smoke near your newborn.

CARE AGREEMENT:

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby.