What to do

1. 

   After you have performed a primary survey, 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 one minute of CPR before calling on a speaker phone.
   • Do not leave the child to make the call or to look for a defibrillator.
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.

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

   • The beat of the song ‘Nellie the Elephant’ can help you keep the right rate.
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.

   Doing rescue breaths may increase the risk of transmitting the COVID-19 virus, either to the rescuer or the child. This may be mitigated by placing a face shield or pocket mask over the child’s mouth.

   It is vital that you perform rescue breaths as 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 follow the voice prompts while you continue with CPR.

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.