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Nasal route to ventilation during basic cardiopulmonary resuscitation in children under two months of age
J Sorribes del Castillo1, C Carrión Pérez, J Sanz Ribera
1Servicio Ordinario de Urgencias de Carlet, Centro de Salud de Carlet, Valencia, Spain.
Insights
Adults struggle to perform infant resuscitation. Studies show most adults cannot adequately seal both the mouth and nose of infants under two months for effective ventilation, recommending nasal route as a preferred method.
Area of Science:
- Pediatric Emergency Medicine
- Cardiopulmonary Resuscitation (CPR) Techniques
Background:
- Established guidelines for infant resuscitation require effective mouth and nose coverage.
- Previous studies have not extensively evaluated the anatomical feasibility of these maneuvers in infants.
Purpose of the Study:
- To assess the feasibility of performing mouth-to-mouth and nose resuscitation on infants under two months.
- To compare adult facial dimensions with infant facial dimensions for ventilation suitability.
Main Methods:
- Facial dimensions of 40 infants (under 1 month and 1 month old) were measured.
- Open-mouth dimensions of 40 adult caregivers were recorded.
- Feasibility of sealing infant mouth and nose by adults was assessed.
Main Results:
- Only 9 adults could seal the mouth and nose of infants under 1 month.
- Only 1 adult (5%) could seal the mouth and nose of 1-month-old infants.
- No adults could perform ventilation as per AHA/ERC guidelines on open-mouthed infants.
Conclusions:
- Adults are anatomically challenged to cover both infant mouth and nose for ventilation.
- The nasal route for ventilation, with oral sealing of the nose, is recommended for infants under two months.
- This approach is advised for teaching and practicing basic CPR in neonates with respiratory arrest.
Abstract:
In order to determine the feasibility of performing mouth to mouth and nose resuscitation according to the established guidelines, a study was carried out on the facial dimensions of 40 children under 2 months of age (20 under 1 month and 20 aged 1 month) and the open-mouth dimensions of the 40 adults in charge of these children. Only nine adults in charge of children under 1 month of age would have been able to seal the mouth and nose of these infants. In the case of the 1 month old infants, only one adult (5%) proved able to encircle the mouth and nose. Strikingly, none of the adults involved in this study would have been able to perform the ventilation manoeuvres in children with open mouths as recommended by the American Heart Association and European Resuscitation Council guidelines. In conclusion, since adults are unable to cover with their mouths both the mouth and nose of the infants, the nasal route to ventilation, with oral sealing of the nose, is recommended as the best approach for the practice and teaching of the basic cardiopulmonary resuscitation (CPR) in children under 2 months of age who have respiratory arrest.