What to do

1. 

   After you have performed a primary survey, and you find the baby is unresponsive and not breathing normally, you should ask a helper to call 999 or 112 for emergency help while you start CPR.

   • If you're on your own, and have a speaker phone, give 5 rescue breaths and then phone 999 or 112.  Continue CPR as directed by the 999 or 112 emergency medical advisor.
   • If you're on your own without a speaker phone, you need to give 5 rescue breaths and one minute of CPR before dialling 999 or 112 for an ambulance.
   • Do not leave the baby to make the call.
   • If you do not have access to a phone, give 5 rescue breaths and do one minute of CPR and then go for help, taking the baby with you.
2. 

   Place the baby on a firm surface and open their airway. To do this, place one hand on their forehead and very gently tilt their head back until their face is flat to the sky. With your other hand, use your fingertip and gently lift the chin.

3. 

   Give five initial puffs. Take a breath and put 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.  If the chest doesn't rise, reposition the airway and/or try and improve the seal and give the next rescue breath.

   Do this five times.

   • If their chest does not rise, move on to CPR.

   It is vital that you perform rescue breaths as cardiac arrest in a baby is likely caused by a respiratory problem.  But equally, you need to stick to an initial 5 rescue breaths and then 30 compressions followed by 2 breaths.  

4. 

   You will then need to give 30 pumps. Put two fingers in the centre of the baby’s chest and push down a third of the depth of the chest (about 4cm). Release the pressure allowing the chest to come back up fully.

   Repeat this 30 times at a rate of 100 to 120 pumps per minute.

   • The beat of the song ‘Stayin' Alive’ can help you keep the right rate, as will the 999 or 112 emergency medical advisor on the phone, who will give you instructions.
5. 

   After 30 pumps, open the airway and give two puffs. Keep alternating 30 pumps with two puffs (30:2) until:

   • emergency help arrives and takes over
   • the baby starts showing signs of life and starts to breathe normally.

     (If you are trained in paediatric BLS, use the 15:2 ratio*).

     * Paediatric basic life support Guidelines | Resuscitation Council UK

6. 

   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.

   Monitor their level of response and prepare to give CPR again if necessary.