The first step seems simple enough but is very important.
Robin Pirie took the silver-skinned infant mannequin and gently patted the sole of its left foot, simulating what Laura and Donovan Jackson should do if they find that one of their infant quadruplets, say Abraham Suneet, is not responsive.
"Abraham," Ms. Pirie called softly. "Abraham sweetie, wake up."
Across the table in a conference room at the Medical College of Georgia, Mr. Jackson mimicked the motion on his own doll.
"So it's like a wake-up call," concluded their oldest son, 12-year-old Derrick Jackson, as he watched Ms. Pirie, a clinical nurse intensivist in the neonatal intensive care unit at MCG's Children's Medical Center.
Recently, a panel of physicians convened by the American Heart Association sent a wake-up call of its own to people who teach cardiopulmonary resuscitation, wondering if squeamishness over mouth-to-mouth resuscitation would prevent some people from even attempting CPR on a stranger. The group concluded that chest compressions should be emphasized.
But those who teach CPR in Augusta said they see little reason to alter the life-saving technique and that the value of the air given in mouth-to-mouth resuscitation is even more important with infants such as the month-old Jackson quadruplets.
The family was required to attend the CPR class before taking the children home to Statesboro, Ga., recently. But many parents sign up on their own because they worry about what might happen if their infant suddenly stops breathing or chokes, said Vicki Smith, who teaches infant and adult CPR at University Hospital.
"That's the question you get: What do I do if my child stops
breathing?" Ms. Smith said.
The warning signs are a dark red face and a lack of an effective cough. If the child appears to be coughing well or is getting air, CPR isn't needed, Ms. Smith said.
Getting air into the child's lungs is the first priority because infant cardiac arrest often results from a lack of oxygen, Ms. Smith said. That's why it was difficult for her to understand the physicians' recommendation.
"That's a strange thing for them to say," Ms. Smith said. "Until you can get air into your child, you don't need chest compressions."
The squeamishness over mouth-to-mouth hasn't been a problem in CPR courses taught locally by the American Red Cross, said safety director Sandra Leathers.
"We really haven't noticed a hesitancy," she said. "(But) when they think about doing CPR, they think about doing it for a family member."
The University and Red Cross courses also offer participants a chance to buy face shields and disposable masks that can shield them from contracting a disease from a stranger, however remote the possibility.
But what happens in real life, out on the street or in a restaurant, will still be up to the individual, Ms. Smith said.
"We tell them to leave that up to your conscience," she said.
If you would like more information on CPR, contact Sandra Leathers at the American Red Cross in Augusta, 724-8481, or Vicki Smith at University Hospital, 774-5892.