CPR Training Your child collapses and is unresponsive. Do you know what to do?

Your quick reaction with a series of simple rescue steps could mean the difference between life and death.

Sudden cardiac arrest (SCA) occurs when the heart suddenly and unexpectedly stops beating. Every year, sudden cardiac arrest strikes almost 400,000 people in the U.S. — one every 90 seconds. The causes of SCA in youth are varied and include heart conditions that result from abnormal heart muscle or abnormal heart structure or function, and primary electrical abnormalities. Outside factors such as drug use or a sudden blow to the chest can contribute to SCA. In adults, SCA is often associated with coronary artery disease, which can cause a heart attack when blood flow to the heart muscle is blocked. The heart attack can trigger an electrical abnormality that leads to sudden cardiac arrest.

Currently, only 10 to 12 percent of people who experience a SCA outside the hospital survive. That’s just a fraction of the survival rate possible if more people knew how to administer cardiopulmonary resuscitation (CPR) and if defibrillation was available within minutes.

While historically thought to be an adult problem, SCA does affect children. Thousands of children die every year from SCA but could have been saved through timely intervention. We spoke with Victoria Vetter, MD, MPH, a cardiologist in the Cardiac Center and Medical Director of the Youth Heart Watch program at Children’s Hospital of Philadelphia (CHOP), and Zane Schultz, program coordinator of the Youth Heart Watch program, for more information.

What you should do when a person becomes unresponsive?

What should you do if a child, a teen or an adult becomes unresponsive and is either not breathing or is only gasping? They might be lying still or shaking, as if having a seizure.

The simple steps are known as the Chain of Survival:

  1. Call 9-1-1 immediately. Seconds count.
  2. If you are in a location with an advanced external defibrillator (AED) nearby, send someone to get it. Victims of SCA can be “brought back” by AEDs if they are available and quickly used.
  3. Start CPR.
    • Lay the person flat on their back on a firm surface.
    • Kneel next to the person’s chest.
    • Place the heel of one of your hands in the center of the person’s chest and put your other hand on top of the first. (Only one hand may be needed for a very small child.)
    • Push hard straight down, elbows locked, at least 2 inches, and push fast: 100-120 compressions a minute until the person wakes up and starts to breathe or medical professionals arrive to help.
  4. Apply an AED when it is brought to you and follow the prompts. Voice commands take the user through the process step by step. When the two pads are placed on the chest as instructed, the AED will recognize if the heart rhythm is not normal and needs to be shocked. It will then tell you whether to continue CPR for another few minutes before the AED checks the rhythm again.
  5. Continue CPR until the AED signals a normal heartbeat, the person wakes up and breathing is normal, or until medical help arrives.

Get training

After a sudden cardiac arrest, there is a five- to six-minute window before death or irreparable brain damage may occur if nothing is done, so it is critical for families to get training.

While you can administer CPR and an AED at the time of a SCA, you’ll be more confident if you’ve received training ahead of time. Find out about CPR training programs in your community. CHOP has a training video on its website, along with links to other helpful CPR resources.

Encourage your family members to get training, too. Studies show that sixth-graders trained in AED use are able to correctly operate them almost as quickly as emergency medical personnel. Middle school students can administer CPR.

Become a family of lifesavers.

Ask and advocate

Find out if teachers and staff in your child’s day care or school are trained in CPR and AED usage and if an AED is available and accessible at your child’s school or athletic events. Does the coach know CPR and AED use? If not, request that they take steps to provide a safer environment for your child, and other children, with training and equipment.

For schools that have proper training, the survival rate for children experiencing sudden cardiac arrest jumps to more than 80 percent.

Suggest they contact CHOP’s Youth Heart Watch program where they can receive consultation on how to become a Heart Safe school and training at no cost.

Contributed by: Victoria Vetter, MD, MPH, and Zane Schultz

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