When a child becomes unresponsive and stops breathing, quick action is crucial. Every second counts in this emergency situation, and knowing the proper first aid techniques can make a life-saving difference.
Immediate cardiopulmonary resuscitation (CPR) is essential for a child who is unresponsive and not breathing, as it helps maintain blood flow to vital organs until professional medical help arrives.
Recognising the signs of an unresponsive child and responding appropriately is vital.
Check for breathing by tilting the child's head back and looking for chest movements. If no breathing is detected, call 999 immediately or ask someone else to do so while you begin CPR.
CPR for children involves a combination of rescue breaths and chest compressions.
Start with five initial rescue breaths, followed by cycles of 30 chest compressions and two rescue breaths. Continue this process until emergency services arrive or the child begins to show signs of life.
Quick action and proper assessment are crucial when encountering an unresponsive child who is not breathing. The first moments are critical for increasing the chances of a positive outcome.
Before approaching the child, ensure the area is safe for both you and the casualty. Look for potential hazards such as electrical wires, traffic, or unstable structures.
Once safety is confirmed, check the child's responsiveness.
Gently tap the child's shoulders and call out loudly. If there's no response, carefully tilt their head back and lift their chin to open the airway. Look, listen, and feel for signs of breathing for up to 10 seconds.
If the child is not breathing normally, it's essential to act swiftly.
Remember the acronym DR ABC:
If the child is unresponsive and not breathing, it's crucial to get emergency help immediately. If you're alone, spend one minute performing rescue breaths and chest compressions before calling 999.
If others are present, instruct someone specific to call 999 whilst you begin first aid.
Provide clear information to the emergency operator:
Stay on the line if possible, as the operator may provide further instructions. If an automated external defibrillator (AED) is available nearby, ask someone to fetch it.
Swift and precise actions are crucial when a child is unresponsive and not breathing. The first steps involve opening the airway and assessing breathing to determine the appropriate course of action.
To open the airway, tilt the child's head back gently using one hand on their forehead. This action pulls the tongue forward, preventing it from blocking the airway.
For infants, ensure the head is in a neutral position, avoiding over-extension.
Place two fingers under the chin and lift it slightly. This manoeuvre helps to open the airway further. Be cautious not to press on the soft tissues under the chin, as this may obstruct breathing.
If there's a suspected neck injury, use the jaw thrust technique instead.
Place your fingers behind the angle of the jaw and gently lift it forward. This method opens the airway without moving the neck.
After opening the airway, check for breathing for no more than ten seconds. Look for chest movement, listen for breath sounds, and feel for air on your cheek.
Normal breathing in children is regular and effortless.
If the child is breathing normally, place them in the recovery position. This involves turning them onto their side with the top leg bent for stability and the head tilted back to keep the airway open.
If there's no breathing or only occasional gasps, begin cardiopulmonary resuscitation (CPR) immediately. Call 999 or ask someone else to do so while you start rescue breaths and chest compressions.
Cardiopulmonary resuscitation is a critical life-saving technique for children who are unresponsive and not breathing. Proper CPR technique, compression-only methods, and rescue breaths are essential components of this procedure.
When performing CPR on a child, begin by placing them on a firm, flat surface. Position yourself next to their chest.
Place the heel of one hand in the centre of the child's chest, between the nipples. For smaller children, you may only need to use one hand.
Push down a third of the depth of the chest. Release the pressure, allowing the chest to come back up fully. Repeat this action at a rate of 100 to 120 compressions per minute.
After 30 compressions, tilt the child's head back gently and lift their chin. Pinch their nose and give two rescue breaths, watching for chest rise.
Continue with cycles of 30 compressions and two breaths until help arrives or the child shows signs of life.
If you're unable or unwilling to give rescue breaths, compression-only CPR can be performed. This method is particularly useful when multiple rescuers are present or in situations where giving mouth-to-mouth is not possible.
To perform compression-only CPR, follow these steps:
Continue chest compressions without pausing for breaths until emergency services arrive or the child shows signs of life.
Rescue breaths are a crucial part of CPR for children.
To give rescue breaths, tilt the child's head back and lift their chin. Pinch their nose closed with your thumb and forefinger.
Take a normal breath, place your mouth over the child's mouth, creating a seal. Blow steadily into their mouth for about one second, watching for their chest to rise.
If the chest doesn't rise, reposition the head and try again.
Give five initial rescue breaths before starting chest compressions. After each set of 30 compressions, give two rescue breaths. Continue this cycle until help arrives or the child shows signs of life.
An AED is a portable device that can restart a heart that has stopped beating. It analyses the heart's rhythm and delivers an electric shock if needed to restore normal function. AEDs are designed to be used by anyone, even those without medical training.
An AED should be used when a child is unresponsive and not breathing. Cardiac arrest can affect people of any age without warning, including children. If a child collapses suddenly and shows no signs of life, an AED may be necessary.
AEDs are often found in public places such as:
It's crucial to start CPR immediately while someone retrieves the AED. The chances of survival decrease by 7-10% for every minute without defibrillation.
Using an AED on a child is similar to using it on an adult, but with a few key differences:
Continue this cycle of CPR and AED analysis until emergency services arrive or the child shows signs of life.
After successfully resuscitating a child, immediate and ongoing care is crucial for their recovery. Proper monitoring and positioning are essential components of post-resuscitation care to optimise outcomes and prevent further complications.
Close observation of vital signs is critical in the post-resuscitation period.
Check the child's breathing rate and depth regularly, ensuring it remains within normal ranges for their age. Monitor heart rate and blood pressure frequently, as these can fluctuate rapidly.
Pulse oximetry should be used to measure oxygen saturation levels. Aim to maintain SpO2 between 94-98%. If available, end-tidal CO2 monitoring can help assess the effectiveness of ventilation and circulation.
Neurological status must be closely monitored.
Assess the child's level of consciousness using the AVPU scale (Alert, Voice, Pain, Unresponsive). Check pupil size and reactivity to light. Watch for signs of increased intracranial pressure, such as headache or vomiting.
Temperature regulation is crucial.
Maintain normothermia, avoiding both hyper- and hypothermia. Use warming or cooling measures as needed to keep the child's temperature between 36-37.5°C.
Proper positioning is vital for maintaining airway patency and preventing aspiration.
Place the child in the recovery position if they are breathing spontaneously but remain unconscious. This involves:
For children requiring continued respiratory support, maintain them in a supine position with the head elevated at 30 degrees. This helps reduce intracranial pressure and minimises the risk of aspiration.
Regularly reassess and adjust the child's position as needed.
Be mindful of pressure points and change position every 2-4 hours to prevent pressure sores. Ensure all tubes and lines are secure and not kinked or obstructed when repositioning.
When emergency services arrive, a calm and organised handover is crucial. Providing clear information and continuing support for the child are essential steps to ensure the best possible care.
When paramedics arrive, provide a concise summary of the situation.
State the child's name, age, and any known medical conditions. Explain when and how you found the child unresponsive and not breathing. Describe the actions you've taken, including the duration of CPR performed.
Inform them of any changes in the child's condition since you began first aid. If known, share details about what led to the emergency. Be prepared to answer questions about allergies, medications, or recent illnesses.
Hand over any relevant medical documents or items, such as an inhaler or EpiPen, if available.
Continue performing CPR until the paramedics instruct you to stop. They may ask you to assist or take over completely. Follow their directions precisely.
Keep the area around the child clear to allow the emergency team easy access.
If possible, have someone direct the paramedics to your exact location.
Comfort any family members present, keeping them calm and out of the way of the medical team. Be prepared to provide contact information for the child's parents or guardians if they're not present.
Offer to accompany the child to the hospital if needed, especially if no family members are available. This can provide continuity of care and reassurance for the child.
After performing first aid on an unresponsive, non-breathing child, proper aftercare is crucial. It involves providing emotional support and ensuring the child receives appropriate medical attention.
The child and their family may experience significant distress following such a traumatic event. Offer calm, reassuring words and a comforting presence.
Explain what happened in simple terms, appropriate for the child's age. Encourage open communication, allowing the child to express their feelings and ask questions.
Create a safe, quiet environment to help reduce anxiety. Maintain physical contact if the child finds it comforting.
Reassure them that they are safe and that medical professionals are there to help.
Be prepared for potential emotional reactions like crying, anger, or withdrawal. These are normal responses to a frightening experience.
If needed, seek professional help to address any lasting emotional impact.
Even if the child has regained consciousness and appears stable, it's essential to obtain immediate medical care. Call emergency services if you haven't already done so.
Provide medical staff with a detailed account of the incident, including:
Follow all medical advice given, including any prescribed medications or follow-up appointments.
Watch for signs of recurring breathing difficulties or changes in consciousness. Inform the child's paediatrician about the incident to ensure proper long-term care.
Consider arranging a check-up with the child's regular doctor within a few days of the event. This allows for a thorough examination and discussion of any ongoing concerns or preventive measures.
Proper first aid techniques are crucial when dealing with an unresponsive, non-breathing child. Swift action and correct procedures can make a life-saving difference in these critical situations.
First, check for responsiveness by gently tapping the child's shoulders and calling their name. If there's no response, tilt their head back to open the airway and check for breathing for no more than 10 seconds.
If the child is not breathing, immediately call 999 for emergency services. Then, begin chest compressions at a rate of two per second.
To perform CPR on a child, place the heel of one hand in the centre of their chest. Push down firmly and quickly at a rate of two compressions per second.
After 30 compressions, give two rescue breaths. Pinch the child's nose, seal your mouth over theirs, and blow steadily for about one second.
Continue this cycle until help arrives or the child starts breathing normally.
Assess the scene for any potential dangers before approaching the child. Check for responsiveness by gently tapping their shoulders and calling out to them.
If there's no response, tilt their head back and look, listen, and feel for breathing for no more than 10 seconds.
If the child is not breathing, immediately call for help and begin CPR.
For an infant, check for responsiveness by tapping the soles of their feet and calling to them. If unresponsive, check for breathing by tilting their head back slightly.
If not breathing, give 5 initial rescue breaths. Cover the infant's mouth and nose with your mouth and blow steadily for 1 second.
Then begin chest compressions using two fingers in the centre of the chest.
If a child becomes unconscious after choking, lay them on a firm, flat surface. Check their mouth for any visible obstructions and remove them if possible.
Begin CPR immediately, starting with chest compressions. The chest compressions may help dislodge the object.
Continue CPR and periodically check the mouth for the obstructing object.
In the UK, immediately dial 999 for emergency services when a child is unresponsive and not breathing.
Request an ambulance and clearly state the situation and location.
Stay on the line with the emergency operator. They can provide guidance on performing CPR and other life-saving measures until professional help arrives.
