Basic Life Support (BLS) for Neonates and Infants: A Step-by-Step Guide
Basic Life Support (BLS) is a critical skill for healthcare providers, emergency responders, and even parents. When it comes to neonatal and infant resuscitation, performing chest compressions correctly can mean the difference between life and death.
In this guide, we’ll cover:
✅ Where to place your hands for chest compressions
✅ How to avoid injuring the baby
✅ Key differences between infant and adult CPR
✅ High-yield tips for medical exams (USMLE, NCLEX, PALS)
Key Steps for Neonatal and Infant CPR
1️⃣ Chest Compression Placement
🔹 Position your hands correctly:
Use two fingers (for single rescuer) or two thumbs encircling the chest (for two rescuers).
Place them at the middle third of the sternum, slightly below the nipple line.
DO NOT press on the xiphoid process (lower end of sternum) → Risk of liver injury
🔹 Compression Depth:
Press at least 1/3 of the chest depth (~1.5 inches or 4 cm).
🔹 Compression Rate:
100-120 compressions per minute (same as adults).
🔹 Compression-to-Ventilation Ratio:
Single rescuer: 30:2 (30 compressions, 2 breaths).
Two rescuers: 15:2 (15 compressions, 2 breaths).
🔹 Airway and Breathing:
If the infant is not breathing, provide gentle breaths using a bag-mask device or mouth-to-mouth technique.
Ensure proper head positioning: Slight tilt (neutral position) to open the airway without hyperextension.
Comparison of Infant vs. Adult CPR
| Aspect | Infant CPR | Adult CPR |
|---|---|---|
| Compression Depth | 1.5 inches (4 cm) | 2 inches (5 cm) |
| Compression Method | 2 fingers (single rescuer), 2 thumbs (two rescuers) | Heel of one or two hands |
| Compression-to-Breath Ratio | 30:2 (1 rescuer), 15:2 (2 rescuers) | 30:2 |
| Airway Position | Neutral head position | Slight head tilt |
| Rescue Breaths | Gentle puffs, mouth-to-mouth or bag-mask | Deep breaths |
Common Mistakes to Avoid
🚫 Pressing on the xiphoid process → Liver damage
🚫 Not compressing deep enough → Ineffective circulation
🚫 Hyperextending the neck → Airway obstruction
🚫 Stopping compressions for too long → Keep interruptions under 10 seconds!
USMLE/PALS/NCLEX Exam Tip
📌 Scenario: A newborn is found unresponsive, not breathing, and has a heart rate of 50 bpm. What is the next step?
💡 Answer: Start chest compressions at a 3:1 compression-to-ventilation ratio (if in neonatal resuscitation). If it's an infant >1 month old, use 15:2 (two rescuer) or 30:2 (single rescuer).
Conclusion
Neonatal and infant BLS is a lifesaving skill that requires precision and practice. Correct hand placement, compression depth, and breathing techniques can improve survival rates and prevent complications.
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Frequently Asked Questions (FAQs)
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