- Ensure safety
- Check responsiveness
- Gently stimulate the child- ask loudly ‘Can you hear me?’ or ‘Are you alright?’
- Do not shake infants; or children with suspected spine injury
- If the child responds with noise or movement
- Leave them in the position they have been found in; check condition and get help; reassess regularly
- If the child responds with noise or movement
- If the child does not respond
- Shout for help
- Turn child onto their back and perform head tilt chin lift in a child (to sniffing air position)
- Jaw thrust can also be used in children, particularly if C-spine injury is suspected
- In infants, lift the chin, if necessary into a neutral position
- Look, listen and feel for breathing for no more than 10 seconds (at this point you may also assess for pulse (carotid in children and brachial in infants; alternatively a femoral))
- If the child is breathing, turn them onto the recovery position (in an infant, leave them lying supine)
- Send for help (call 999 etc) and reassess frequently
- If the child is breathing abnormally (e.g. snoring/obstructed), carefully remove any obvious obstruction (do NOT perform finger sweeps) then if still abnormal ->
- If the child is breathing, turn them onto the recovery position (in an infant, leave them lying supine)
- If the child is not breathing
- Give 5 rescue breaths (over mouth for child and over nose and mouth in an infant)
- If unsuccessful, reassess airway and try again (attempt a maximum of 5 times)
- If there is a pulse, continue rescue breathing until help arrives or until the child starts breathing
- Give 5 rescue breaths (over mouth for child and over nose and mouth in an infant)
- If there is no pulse, start chest compressions
- In children, compress the lower half of the sternum (one fingerbreadth above the xiphisternum) by about a third of the depth of the chest (hard and fast) with the heel of your hand.
- In infants, compress the chest with the tips of two fingers
- 15 chest compressions at around 100-120bpm
- Give 2 rescue breaths and repeat compressions at 15:2
- If help has not been sought by another, seek help after a minute of resuscitation UNLESS there has been a witnessed sudden collapse which suggests a shockable rhythm (get help ASAP)
- In children, compress the lower half of the sternum (one fingerbreadth above the xiphisternum) by about a third of the depth of the chest (hard and fast) with the heel of your hand.