What to do

1. 

   After you have performed a primary survey, (check for response, open the airway and check for normal breathing and signs of life for no more than 10 seconds). If you find that the child is unresponsive and not breathing, you should ask a helper to call 999 or 112 for emergency help while you start CPR. Ask a helper to find and bring a defibrillator, if available.

   • If you are on your own, you need to give five rescue breaths first, then dial 999 or 112 on a speaker phone and start chest compressions. If you don't have a speaker phone, give one minute of CPR before calling 999 or 112.
   • Do not leave the child to make the call or to look for a defibrillator, unless you do not have a mobile phone and there is no help available. If this happens, go for help after giving one minute of CPR.
2. 

   Start CPR. Place them on a firm surface and open their airway. To do this, place one hand on their forehead to tilt their head back and use two fingers from the other hand to gently lift the chin.

3. 

   Give five initial rescue breaths.

   Take the hand from the forehead and pinch the soft part of the nose closed, allowing the mouth to fall open.

   With the head still tilted, take a breath and put your mouth around the child’s, to make a seal.

   Blow into their mouth gently and steadily for up to one second, until the chest rises.

   Remove your mouth and watch the chest fall.

   That’s one rescue breath. Do this five times.

4. 

   You will then need to give 30 chest compressions.

   Kneel by the child and put one hand in the centre of the child’s chest.

   Push down a third of the depth of the chest.

   Release the pressure allowing the chest to come back up fully.

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

   • The beat of the song ‘Stayin' Alive’ can help you keep the right rate and the emergency medical advisor will tell you what speed you need to push at.

        

    

5. 

   After 30 compressions, open the airway and give two breaths.

   Keep alternating 30 compressions with two breaths (30:2) until:

   • emergency help arrives and takes over
   • the child starts showing signs of life and starts to breathe normally
   • a defibrillator is ready to be used.

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

         * Paediatric basic life support Guidelines | Resuscitation Council UK

   It is vital that you perform rescue breaths as a cardiac arrest in a child is likely caused by a respiratory problem.

6. If the helper returns with a defibrillator, ask them to switch it on and take the pads out while you continue with CPR. They should remove or cut through clothing to get to the casualty's bare chest. They also need to wipe away any sweat.

   • The defibrillator will give voice prompts on what to do

   They should attach the pads to the casualty’s chest by removing the backing paper. Applying the pads in the positions shown.

   • The first pad should be on the upper right side below the collar bone.
   • The second pad should be on the casualty’s left side below and in line with the arm pit.

   The defibrillator will analyse the heart's rhythm. Stop CPR, and make sure no one is touching the casualty. It will then give a series of visual and verbal prompts that should be followed.

   • If the defibrillator tells you that a shock is needed, tell people to stand back. The defibrillator will tell you when to press the shock button. After the shock has been given, the defibrillator will tell you to continue CPR for two minutes before it re-analyses.
   • If the defibrillator tells you that no shock is needed, continue CPR for two minutes before the defibrillator re-analyses.

    

7. 

   If the child shows signs of becoming responsive such as coughing, opening eyes, speaking, and starts to breathe normally, put them in the recovery position. Monitor their level of response and prepare to give CPR again if necessary.

   • If you have used a defibrillator, leave it attached.