While rare, sudden cardiac arrest (SCA) can affect infants, children and teens and can be fatal if cardiopulmonary resuscitation (CPR) is not administered quickly – usually in a matter of minutes. Structural or functional problems with a child's heart, irregular heart rhythms (arrhythmias) or genetic syndromes can increase the risk of SCA. While some of these conditions are identified, monitored and treated from birth, certain rhythmic or structural problems don't produce symptoms until SCA occurs. Frequently dangerous heart conditions are recognized when a family history of SCA is present.
Are there symptoms prior to sudden cardiac arrest?
Some children at risk for SCA display symptoms in the days, weeks or months leading up to an episode, including dizziness, chest pain with exertion, unexplained fainting, palpitations or difficulty breathing. If your child exhibits any of these warning signs, take him or her to a doctor. If you have a family history of premature sudden deaths, heart failure or other heart conditions, talk to your child's doctor about a thorough cardiac evaluation.
What happens during cardiac arrest?
SCA can occur at rest or during exertion. During cardiac arrest, the heart can no longer pump oxygen-rich blood to the brain and vital organs. In other words, the heart stops. But, when CPR and/or an automated external defibrillator (AED) are administered within the first few minutes after a child collapses with SCA, that child has a 75 percent greater chance of surviving. CPR pumps oxygen-rich blood to the brain and major organs, and an AED can deliver a lifesaving shock to the heart and get it beating effectively again. Anyone can perform CPR for children or for infants to help save a life. Training is available from the American Heart Association.
How to perform CPR on a child
The American Heart Association recommends that everyone - untrained, trained or medical personnel - begin CPR for children with chest compressions.
First, shout or shake the child gently to check for responsiveness. Tell someone to call 911 right away and to find the nearest AED.
Here are the steps for CPR:
- Place the heel of your hand on the center of the child's chest.
- Place the heel of your other hand on top of your first hand, lacing your fingers together.
- Keep your arms straight and your shoulders over your hands.
- Push hard and fast, compressing the child's chest at least 2 inches.
- Let his or her chest rise completely before pushing it down again.
- Give 30 chest compressions quickly. Only stop if he or she starts breathing normally or an emergency responder takes over.
If you've been trained in CPR for children, and you've performed 30 chest compressions, put your palm on the child's forehead and gently make sure his or her head is tilted back. The chin needs to be lifted to open the airway. If there is an obstruction – like candy or chewing gum – remove it. You can then perform rescue breathing.
- Check for normal breathing and chest movements.
- If the child is gasping or not breathing, pinch his or her nostrils shut and cover the child's mouth with yours – forming a seal.
- Blow into his or her mouth and see if the chest rises. If it does, give one more breath and alternate with 30 chest compressions followed by two breaths. Some experts recommend five rescue breaths for infants and young children.
- If the chest doesn't rise, tilt the child's head back more to open the airway and begin again.
When performing CPR for infants, flick your fingers against a baby's feet to check for responsiveness. Compress the baby's chest using several fingers, following the steps above. If you're giving rescue breaths, you may need to cover his or her mouth and nose with your mouth to form a seal.
“We cannot prevent all SCA. Everyone, particularly parents, should learn CPR and know how to use an AED.” To find a CPR training near you, visit the American Heart Association's CPR & First Aid page.
Make sure your child's school has an emergency action plan for SCA. Project ADAM can help your school develop an emergency program if there is not one in place already.
The experts at the Heart Center at Children's Health℠ care for all children's heart conditions, from congenital heart defects to heart disease. Find out how they can help keep your child's heart healthy.
Stay current on the health and wellness information that makes a difference to you and your family. Sign up for the Children's Health newsletter to have more expert tips and insights sent directly to your inbox.