Always remember DRABC.
Upon discovering that a child is unresponsive and not breathing you should ask someone to call 999 or 112 for an ambulance while you start CPR.
Ask someone to find a public defibrillator (AED) if available.
- If you are on your own, it is important that you give one minute of CPR before calling 999/112 on a phone hands-free.
- Do not leave the child unattended while you to make the call or go seek a defibrillator.
Danger. Make sure the area is safe before approaching the baby.
Response. Check to see if the baby is responsive or unresponsive. As you are approaching them, call their name out loud. Tap the bottom of the baby’s foot gently to see if they respond.
- They are responsive if If they open their eyes, or give any another gesture.
- If they do not respond in any way they are unresponsive and should be treated urgently.
Airway. Then you need to check to see if the baby’s airway is open and clear.
To open the airway, place one hand on the baby’s forehead and very gently tilt their head back. Use your other hand’s fingertip to gently lift the chin.
- If the baby is unresponsive it is important that you move on to breathing as fast as possible.
- If they are responsive but their airway has an obstruction, you need to clear the airway immediately.
Breathing. Is the baby is breathing normally?
Place your ear above their mouth and look down towards their feet, so you can see their tummy and chest.
Listen for breathing sounds and see if you can feel their warm breath on your cheek. Watch to see if their chest moves. Do this for 10 seconds.
- If the baby is unresponsive, you need to call 999/112 for an ambulance immediately and start CPR.
- If the baby is responsive and breathing move on to circulation.
Circulation. Once you have established that they are responsive and breathing, look and check for any signs of severe bleeding.
- If they are bleeding severely you will need to control and treat the bleeding by applying direct pressure to the wound. Call 999/112 for emergency help.
- If the baby is unresponsive and breathing but with no bleeding, put them in on their side (recovery position) call 999/112 for an ambulance.
Once you have completed this primary survey and have treated any life-threatening issues it is time to move on to start CPR.
Place the baby on a firm surface and open their airway.
To do this, as described earlier, To open the airway, place one hand on the baby’s forehead and very gently tilt their head back. Use your other hand’s fingertip to gently lift the chin.
Give five gentle puffs initially. Do this by taking a breath and put your mouth, not your lungs, placing your mouth around the baby’s mouth and nose to make a seal, and blow gently and steadily for up to one second.
The chest should rise. Remove your mouth and watch the chest fall. That’s one rescue breath, or puff, one rise and one fall.
Do this five times.
- If the baby’s chest does not rise, check to see if the airway is open.
Now give 30 pumps on the chest.
To do this, place two fingers in the centre of the baby’s chest and press down to about a third of the depth of their chest. Then release that pressure so that their chest returns up.
Repeat this action 30 times at the rate of 100 to 120 pumps per minute.
After those 30 pumps, open the airway again and give two breaths/puffs.
Keep alternating 30 chest pumps with two puffs (a ratio of 30:2) until the ambulance arrives, someone else takes over or the baby starts to show signs of life .
If the baby shows signs of becoming responsive, such as, coughing, opening their eyes, making a noise, or starts to breathe normally, put them in the recovery position, as in the image below.
Monitor their level of response, keep checking they are still breathing and be prepared to give CPR again if they stop breathing..