As you know, some Emergency First Response® skills vary depending on where the course is conducted. EFR® Instructor Guides include directions to refer to the actual guidelines produced by the council or organization having authority in your region when in doubt about a particular treatment protocol or procedure.
When teaching EFR Care for Children courses in areas where European Resuscitation Council (ERC) Guidelines (2021) apply, please note the following:
Infant and Child Age
ERC guidelines define infants as individuals under the age of one year, and children as individuals aged between one and 18 years old. Adult guidelines may be used for anyone who appears to be an adult. Responders trained in adult-only CPR techniques may use the adult techniques and procedures on children, adapting the technique depending on the size of the child.
Infant and Child CPR Ratios
During pediatric CPR courses, laypeople may be trained to provide five initial rescue breaths, then perform CPR using a ratio of 15 chest compressions to two breaths. It is important to note that responders who have only been trained in adult CPR may continue to use the ratio of 30:2.
Infant Chest Compression Techniques
ERC guidelines note two recommended techniques for infant chest compressions. In addition to the two-finger technique outlined in the EFR Care for Children Instructor Guide and student materials, EFR Instructors may teach the use of a two-thumb encircling technique.
Steps for the two-thumb encircling technique include:
- Place both thumbs side by side on centre of the chest on the lower half of the sternum. The fingers wrap around the ribcage toward the back.
- Use both thumbs at the same time to compress the chest by about one-third of the infant’s chest depth.
- Wait to ensure the chest recoils to its normal position after each compression.
Note that the two-thumb encircling technique should only be used by laypeople who have received training in this technique.
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