Check for responsiveness
1. Check for responsiveness. Shake or tap the child gently. See if the child moves or makes a noise. Shout, "Are you OK?"
2. If there is no response, shout for help. Send someone to call 911 and retrieve an automated external defibrillator (AED) if one is available. Do not leave the child alone to call 911 and retrieve an AED until you have performed CPR for about 2 minutes.
3. Carefully place the child on their back. If there is a chance the child has a spinal injury, two people should move the child to prevent the head and neck from twisting.
4. Perform chest compressions:
- Place the heel of one hand on the breastbone -- just below the nipples. Make sure your heel is not at the very end of the breastbone.
- Keep your other hand on the child's forehead, keeping the head tilted back.
- Press down on the child's chest so that it compresses about 1/3 to 1/2 the depth of the chest.
- Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be FAST and hard with no pausing. Count the 30 compressions quickly: "1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off."
Child not breathing
5. Open the airway. Lift up the chin with one hand. At the same time, push down on the forehead with the other hand.
6. Look, listen, and feel for breathing. Place your ear close to the child's mouth and nose. Watch for chest movement. Feel for breath on your cheek.
7. If the child is not breathing:
- Cover the child's mouth tightly with your mouth.
- Pinch the nose closed.
- Keep the chin lifted and head tilted.
- Give two breaths. Each breath should take about a second and make the chest rise.
8. Continue CPR (30 chest compressions followed by 2 breaths, then repeat) for about 2 minutes.
9. After about 2 minutes of CPR, if the child still does not have normal breathing, coughing, or any movement, leave the child if you are alone and call 911. If an AED for children is available, use it now.
10. Repeat rescue breathing and chest compressions until the child recovers or help arrives.
If the child starts breathing again, place them in the recovery position. Periodically re-check for breathing until help arrives.