If you live or work with infants or small childen, it is important that you receive training in infant and child cardiopulmonary resuscitation or CPR. It may help to review written infant and child CPR instructions but training with a certified teacher is recommended. Training is typically available from the American Red Cross, American Heart Association, and from local hospitals and parents groups.
Assess Situation
Try tapping the baby or child's shoulder while saying his name. Small infants may respond better to flicking their feet. If there is no response, assess the situation. Could the infant or child be choking? If so, immediately follow choking guidelines. If choking is not the likely cause of loss of consciousness, continue to follow CPR instructions.
Call For Help
Shout for someone to call 911. If you are alone, perform CPR for about two minutes and then go call 911. It is important that an emergency response team is activated as soon as possible as professional assistance is often the only chance for survival.
Assess Breathing
Place your cheek in front of the mouth while looking down towards the toes. Infants and small children tend to be belly breathers so check for any raising of the stomach or chest.
Give Breaths
While lifting the chin, tilt the head back slightly. If you tilt the head back too far it can close the airway further. Cover an infant's mouth and nose with your mouth. Pinch a child's nose closed and seal your mouth over his. Count to one second while exhaling. Do not over ventilate as this can cause complications. Pause and then repeat. The chest should rise with each breath. If the chest does not rise attempt to reposition the airway, being careful not to tilt the head back too much. If the chest still does not rise, follow choking protocols.
Chest Compressions
If the child or infant does not cough or still appears to not be breathing, immediately start chest compressions. Place one hand on the forehead to maintain the head position. With the other hand, find the middle of the chest, just below the nipples and place two fingers there for an infant or the heel of the hand for a child. Avoid pressing on the very tip of the breast bone as this can cause further damage. Give 30 chest compressions in rapid succession while making sure to let the chest completely rise after each compression. The depth of the compressions for infants and children should be one-third to one-half the depth of the chest.
Repeat
Repeat two rescue breaths to every 30 chest compressions until further help arrives. If no one has responded to your shout for help, cease CPR after three cycles or about two minutes and contact emergency medical services. Then immediately return to CPR until help arrives.
Warning
Always perform CPR in a safe environment, away from hazards such as electricity or water, and on a hard surface. Do not administer chest compressions if the victim appears to be breathing or coughing. The American Heart Association no longer recommends checking for a pulse before chest compressions unless you are a trained professional. Do not begin chest compressions in cases of heavy bleeding until the bleeding has been stopped with first aid.
