Pregnancy and baby

How to resuscitate a child

Below is the full detailed cardiopulmonary resuscitation (CPR) sequence for infants and children. It's highly recommended that every parent goes to a first aid course as it makes this process much easier to understand and remember.

In a life-threatening emergency, dial 999. If your child is coughing or is wheezy, call NHS 111 or your GP for advice.

Child and baby CPR steps

1. Ensure the area is safe

  • Check for hazards, such as electrical equipment or traffic.

2. Check your child's responsiveness

  • Gently stimulate your child and ask loudly, "Are you all right?".
  • Don't shake infants or children with suspected neck injuries. 

3A. If your child responds by answering or moving

  • Leave them in the position in which they were found (provided they're not in danger).
  • Check their condition and get help if needed.
  • Reassess the situation regularly.

3B. If your child doesn't respond

  • Shout for help.

If the child is under one year old:

  • Ensure that the head is in a neutral position, with the head and neck in line and not tilted.
  • At the same time, with your fingertip(s) under the point of your child's chin, lift the chin. Don't push on the soft tissues under the chin as this may block the airway.

If the child is over one year old:

  • Open your child's airway by tilting the head and lifting the chin.
  • To do this, place your hand on their forehead and gently tilt their head back, leaving them in the position in which you found them.
  • At the same time, with your fingertip(s) under the point of your child's chin, lift the chin. Don't push on the soft tissues under the chin as this may block the airway.
  • This may be easier if the child is turned carefully on to their back.

If you think there may have been an injury to the neck, tilt the head carefully, a small amount at a time, until the airway is open.

4. Keeping the airway open, look, listen and feel for normal breathing by putting your face close to your child's face and looking along their chest

  • Look for chest movements.
  • Listen at the child's nose and mouth for breathing sounds.
  • Feel for air movement on your cheek.

Look, listen and feel for no more than 10 seconds before deciding that they're not breathing.

5A. If your child is breathing normally

  • Turn them on to their side.
  • Check for continued breathing.

5B. If your child isn't breathing or is breathing infrequently and irregularly

  • Carefully remove any obvious obstruction in the mouth.
  • Give five initial rescue breaths (see below).
  • While doing this, note any gag or cough response. 

Rescue breaths (or mouth-to-mouth resuscitation) for a baby under one year

  • Ensure that the head is in a neutral position and lift the chin.
  • Take a breath and cover your baby's mouth and nose with your mouth, making sure it's sealed. If you can't cover both the mouth and nose at the same time, just seal one with your mouth. If you choose the nose, close the lips to stop air from escaping.
  • Blow a breath steadily into the baby's mouth and nose over 1 to 1.5 seconds. It should be sufficient to make the chest visibly rise.
  • Keeping their head tilted and chin lifted, take your mouth away and watch for the chest to fall as air comes out.
  • Take another breath and repeat this sequence five times.

Rescue breaths (or mouth-to-mouth resuscitation) for a child over one year

  • Tilt the head and lift the chin.
  • Close the soft part of their nose using the index finger and thumb of the hand that's on their forehead.
  • Open their mouth a little but keep the chin pointing upwards.
  • Take a breath and place your lips around their mouth, making sure it's sealed.
  • Blow a breath steadily into their mouth over about 1 to 1.5 seconds, watching for the chest to rise.
  • Keeping their head tilted and chin lifted, take your mouth away and watch for the chest to fall as air comes out.
  • Take another breath and repeat this sequence five times. Check that your child's chest rises and falls in the same way as if they were breathing normally.

5C. If you have difficulty achieving effective breathing in your child, the airway may be obstructed

  • Open the child's mouth and remove any visible obstruction. Don't poke your fingers or any object blindly into the mouth.
  • Ensure that there's adequate head tilt and chin lift, but that the neck is not overextended.
  • Make up to five attempts to achieve effective breaths (enough to make the chest visibly rise). If still unsuccessful, move on to chest compressions combined with rescue breaths.

6. Chest compressions – general guidance

  • To avoid compressing the stomach, find the point where the lowest ribs join in the middle, and then one finger's width above that. Compress the breastbone.
  • Push down by roughly one-third of the depth of the chest.
  • Release the pressure, then rapidly repeat at a rate of about 100 compressions a minute.
  • After 30 compressions, tilt the head, lift the chin and give two effective breaths.
  • Continue compressions and breaths in a ratio of two breaths for every 30 compressions.

Although the rate of compressions will be 100 a minute, the actual number delivered will be less than 100 because of the pauses to give breaths.

The best method for compression varies slightly between infants and children.

Chest compression in babies less than one year old

  • Do the compressions on the breastbone with the tips of two fingers, not the whole hand or with two hands.

Chest compression in children over one year

  • Place the heel of one hand over the lower third of the breastbone (as described above).
  • Lift the fingers to ensure that pressure is not applied over the ribs.
  • Position yourself vertically above the chest and, with your arm straight, compress the breastbone so that you push it down by approximately one-third of the depth of the chest.
  • In larger children, or if you're small, this may be done more easily by using both hands with the fingers interlocked, avoiding pressure on the ribs.

If nobody has responded to your shout for help at the beginning and you're alone, continue resuscitation for about one minute before trying to get help (for example, by dialling 999 on a mobile phone).

7. Continue resuscitation until

  • Your child shows signs of life (normal breathing, coughing, movement of arms or legs).
  • Further qualified help arrives.
  • You become exhausted.

Further information on first aid

Page last reviewed: 06/01/2014

Next review due: 06/01/2016


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