Many children do not receive resuscitation because potential rescuers fear causing them harm. It is far better to perform 'adult style' resuscitation on a child (who is unresponsive and not breathing) than to do nothing. However there are a few minor modifications that will make it even more suitable.
First aiders can use the adult sequence with the following modifications:
- Give 5 initial rescue breaths before starting chest compressions (then continue CPR at 30 chest compressions to 2 rescue breaths).
- If you are on your own, give CPR for 1 minute before going for help.
- Compress the chest by at least one-third of its depth (4cm for a baby and 5cm for a child).
- For a baby use 2 fingers.
- For a child use 1 or 2 hands as required.
CPR for children and babies
- Make sure you, the casualty and any bystanders are safe.
- Quickly check to see if the casualty is conscious. Gently shake or tap the shoulders and ask loudly 'are you ok?'
Turn the casualty onto their back if necessary and open the airway:
- Place your hand on the forehead and gently tilt the head back.
- Using your fingertips, lift the chin to open the airway.
- Look, listen and feel for normal breathing for no more than 10 seconds. If they are not breathing normally prepare to start CPR.
- Give 5 initial rescue breaths before starting chest compressions.
- For a child, pinch the soft part of the nose. Allow the mouth to open, but maintain the chin lift. Take a normal breath and seal your lips around the casualty's mouth.
- For a baby, allow the mouth to open, but maintain the chin lift. Take a normal breath and seal your lips around the mouth and nose.
- Blow steadily into the mouth (and nose for a baby), while watching for the chest to rise, taking about one second.
- Keeping the airway open, take your mouth away from the casualty and watch for the chest to fall as air comes out.
- Take another normal breath and blow in the casualty's mouth (and nose for a baby) once more to achieve a total of 5 rescue breaths.
Call 999 and send for a defibrillator (AED)
- If you are on your own, give CRP for 1 minute before going for help.
- If a helper is available ask them to call 999. If you make the call, try to use the speakerphone and stay with the casualty.
- Send someone to get an AED if available.
After you have performed the initial 5 rescue breaths start chest compressions.
- For a child, place the heel of one hand in the centre of the chest (interlock your second hand and use this if you think it necessary), for a baby use 2 fingers.
- Press down on the breastbone to a depth of at least one-third of its depth (4cm for a baby and 5 for a child) and then release all the pressure without losing contact between your hands and the chest.
- Avoid applying pressure over the ribs, the bottom end of the breastbone or the upper abdomen.
- Do 30 chest compressions at a rate of 1-2 per second.
After 30 chest compressions, open the airway again and give 2 rescue breaths this time.
Continue with chest compressions and rescue breaths at a ratio of 30 compressions to 2 breaths. When others are available to help, try to changeover (with minimum delay) every 3 or 4 cycles, to prevent fatigue. Do not stop CPR until a paramedic or a healthcare professional tells you to or, the casualty starts breathing normally.
Remember - even if you do not want to do rescue breaths, you can still use hands-only CPR.