Background Information on Adolescent CPR

Cardiopulmonary resuscitation (CPR) is an emergency procedure used "to restore and maintain breathing and circulation and to provide oxygen and blood flow to the heart, brain, and other vital organs" (Encyclopedia of Children's Health). The procedure combines chest compressions with artificial respirations. CPR may be combined with the use of an Automated External Defibrillator (AED), a device that delivers an electric shock to the heart to get it beating again. 

According to the American Heart Association (AHA), in the pediatric age range, cessation of the heartbeat is most common in infants and teenagers (2000). CPR must be given immediately to an unconscious teenager who has stopped breathing and/or who has suffered cardiac arrest. Among adolescents, common causes of respiratory and/or cardiac arrest include traumatic brain injury, near-drowning, anaphylaxis, alcohol poisoning, drug overdose, sudden cardiac arrest (SCA), and strangulation. 

Most parents do not want to even think of their child being in danger of death. However, it is important for parents and caregivers to be aware of the accidents that can afflict teens and to know how to administer CPR if an emergency involving a youngster occurs. The ideal way to do this is to take a formal CPR and first aid course that will give hands-on practice. These classes are taught by the Red Cross and the AHA. 

CPR for infants and children follows slightly different guidelines than CPR performed on adults. CPR for adolescents, however, is not viewed as separate but is usually grouped with adult CPR. According to the Red Cross's guidelines for CPR, an adult is defined as anyone who has reached puberty. Puberty is recognized by breast development (in girls) or underarm hair (in boys). These signs may be present at ages 12 (more likely for girls) to 14 (more likely for boys). 

It is maintained that teenagers generally weigh enough to be administered adult CPR. Despite this guideline, there are times when a "small adolescent" is thought to be a child by the rescuer (AHA, 1988, p. 63). If in this case the rescuer carries out child CPR, there will be no adverse effects, seeing as teens often need basic life support for the same reasons as younger individuals (Safranek, et. al, 1992, as cited in Maconochie, et. al, 2015).   

Teenagers, like children, are generally most likely to go into cardiac arrest due to interruption of breathing. The opposite is true for adults, whose hearts usually stop beating from a cardiovascular cause. However, sudden cardiac arrest can occur in adolescents, particularly in those who are involved in sports. If a teen suddenly collapses, an adult can perform hands-only CPR even if he or she has not been trained in formal CPR. Hands-only CPR relies solely on chest compressions to keep the victim alive, while omitting rescue breaths. However, this technique should only be used if the rescuer witnesses the teenager's collapse. Otherwise, standard CPR should be given so that the youngster can receive adequate ventilation. Indeed, a general rule of thumb to remember is: "If the person is an adolescent, CPR with rescue breaths is preferred" (Global First Aid Reference Center, 2020, p. 3). This is because teens have usually been starved of oxygen before their young hearts stop.    

Compressions with rescue breathing would be especially crucial in the event of a drug overdose or near drowning of a young person. An insightful research study based in Japan found that CPR with rescue breaths for children ages 1-17 was more effective than compression-only CPR (Goto, Funada, & Goto, 2017). 

In the next blog, we will go over the steps of Adolescent CPR.  

References

American Heart Association. (2000). Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 9: pediatric basic life support. Circulation, 102(8 Suppl), I253–I290. https://pubmed.ncbi.nlm.nih.gov/10966678/

American Heart Association. (1988). Healthcare provider's manual for basic life support.    AHA. https://www.google.com/books/edition/Healthcare_Provider_s_Manual_for_Basic_L/vsxrAAAAMAAJ?hl=en&gbpv=0 

Encyclopedia of Children's Health. (n. d.). Cardiopulmonary resuscitation. Encyclopedia of Children's Health.  http://www.healthofchildren.com/C/Cardiopulmonary-Resuscitation.html#ixzz5FCUE7hsz

Global First Aid Reference Center. (2020). Unresponsive andabnormal breathing (adolescent and adult). IFRC. https://www.globalfirstaidcentre.org/unresponsive-and-abnormal-breathing-adolescent-and-adult/?pdf=19354 

Goto, Y, Funada, A., & Goto, Y. (2017). Conventional versus chest-compression-only cardiopulmonary resuscitation by bystanders for children with out-of-hospital cardiac arrest. Resuscitation,122,1-144.

https://pubmed.ncbi.nlm.nih.gov/29056524/

Maconochie, I. K., Bingham, R., Eich, C., López-Herce, J., Rodríguez-Núñez, A., Rajka, T., Van de Voorde, P., Zideman, D. A., Biarent, D., & Paediatric life support section Collaborators (2015). European resuscitation council guidelines for resuscitation 2015: Section 6. Paediatric life support. Resuscitation, 95, 223–248. https://doi.org/10.1016/j.resuscitation.2015.07.028