First Responder EMS Curriculum for Training Centers in Eurasia

• Place the two fingers of one hand over the lower half of the sternumapproximately one finger's width below the intermammary line, ensuring that youare not on or near the xiphoid process.• Press down on the sternum to depress it approximately one third to one half thedepth of the infant's chest. This will correspond to a depth of about ½ to 1 inch(1½ to 2½ cm). After each compression, completely release the pressure on thesternum and allow the sternum to return to its normal position without lifting yourfingers off the chest wall.• Compress the sternum at a rate of at least 100 times per minute (this correspondsto a rate that is slightly less than 2 compressions per second during the groups of 5compressions).• After five compressions, open the airway with a head tilt-chin lift (or, if trauma ispresent, use the jaw thrust) and give one effective breath. Be sure that the chestrises with the breath.• Continue compressions and breaths in a ratio of 5:1 (for one or two rescuers).6. Two thumb-encircling hands technique (two-rescuer technique):Figure 4. Two thumb-encircling handschest compression technique in infant (tworescuers)• Place both thumbs side by side over the lower half of the infant's sternum,ensuring that the thumbs do not compress on or near the xiphoid process.• Encircle the infant's chest and support the infant's back with the fingers of bothhands. Place both thumbs on the lower half of the infant's sternum, approximatelyone finger's width below the intermammary line.• With your hands encircling the chest, use both thumbs to depress the sternumapproximately one third to one half the depth of the child's chest. This willcorrespond to a depth of approximately ½ to 1 inch.• After each compression, completely release the pressure on the sternum and allowthe sternum to return to its normal position without lifting your thumbs off thechest wall.• Compress the sternum at a rate of at least 100 times per minute (this correspondsto a rate that is slightly less than 2 compressions per second during the group of 5compressions).• After five compressions, pause briefly for the second rescuer to open the airwaywith a head tilt-chin lift (or, if trauma is suspected, with a jaw thrust) and give oneeffective breath (the chest should rise with the breath). Compressions andventilations should be coordinated to avoid simultaneous delivery and ensureadequate ventilation and chest expansion, especially when the airway isunprotected. Continue compressions and breaths in a ratio of 5:1 (for one or tworescuers).First Responder EMS Curriculum/AIHA, July 2002 281