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from Section 2 - Basics in cardiopulmonary resuscitation of newborn infants
Published online by Cambridge University Press: 05 March 2012
! At a cardiac arrest, the first procedure is to take your own pulse
Indication
Heart rate remains below 60 bpm, despite 30 s of effective PPV (FiO2 0.21–1.0; bag-and-mask ventilation or immediate intubation/PPV).
Goals
External cardiac massage: (1) compression of the heart muscle against the spinal column; (2) increase in intrathoracic pressure, and (3) sufficient perfusion and oxygenation of vital organs (particularly central nervous system, coronary arteries, lungs).
The indication for chest compressions (i.e., heart rate below 60 bpm) is also an indication for rapid endotracheal intubation, which helps to ensure adequate ventilation and facilitates the coordination of chest compressions with ventilation (after intubation, the ratio of chest compressions to delivered breaths remains 3:1). Moreover, epinephrine can be given via the ET tube when there is no umbilical vein catheter (UVC), peripheral intravenous (PIV) or intraosseous (IO) access.
Technique
There are two methods:
Two-thumb (encircling hands) technique
Two-finger technique
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