Brief overview
- Procedure: Check if the child is responding and breathing, call 911. If the child is unresponsive and not breathing normally, perform chest compressions and rescue breathing until EMS arrives or the child shows signs of life again.
- Risks: Cardiac massage can break ribs and injure internal organs.
Caution.
- Often swallowed objects are the reason why children stop breathing. Check the mouth and throat to see if you detect anything.
- Never shake an unconscious/not breathing child, especially a baby! You could seriously injure it by doing so.
- Alert the emergency services as soon as possible!
How does resuscitation work in a child?
If a child loses consciousness and is not breathing properly or not breathing at all, you must start resuscitation (cardiopulmonary resuscitation) immediately!
It is normal that you may feel nervous or almost panic. But remember: It is better to risk a mistake during resuscitation (for example, out of panic) than to do nothing at all!
Resuscitation: Baby
“Baby” or “infant” refers to children up to the end of the first year of life. When resuscitating them, proceed as follows:
- Supine position: Lay the baby flat on its back, preferably on a hard surface (such as the floor).
- Head in neutral position: Put the baby’s head in a normal, i.e. neutral position (do not overstretch!).
- 5 x breaths at the beginning: If the baby is not breathing or not breathing properly, or if you are unsure about this, you should ventilate him or her immediately, using the mouth and nose at the same time: Start with five breaths.
- Breath delivery and chest compressions alternately: Now deliver breaths twice more before performing chest compressions again (untrained rescuers 30 times, experienced rescuers 15 times). Continue this 30:2 or 15:2 cycle until either the emergency physician arrives or the baby is breathing on its own again. In the second case, you should place it in the recovery position if it remains unconscious.
Resuscitation: Child (one year and older)
Cardiopulmonary resuscitation (chest compressions and ventilation) in children one year and older is similar:
- Open the airway and check breathing: Proceed as you would with babies. However, you can slightly hyperextend the head of children over one year of age if necessary.
- 30 x or 15 x cardiac massage: (as an untrained helper) perform cardiac massage 30 times by rhythmically pressing the center of the child’s chest (rather the lower half of the sternum) with the heel of your hand (approx. 4-5 cm deep). As with babies, a frequency of up to 120 per minute (but at least 100/min) is recommended, i.e., about twice per second. As a trained helper and with several co-helpers, press 15 times.
The 15:2 cycle (15 chest compressions alternating with 2 resuscitations) is recommended as a priority when resuscitating children. If a rescuer uses the 30:2 cycle recommended for adults instead due to ignorance or inexperience, this is better than not resuscitating the young patient at all! In addition, several rescuers should always be present for the 15:2 cycle. For single rescuers, the 30:2 cycle is more appropriate.
When do I resuscitate children?
In adults, on the other hand, the heart is more often responsible for respiratory and circulatory arrest and unconsciousness. For this reason, resuscitation is started with cardiac massage (followed by ventilation).