The following steps are based on instructions from the American Heart Association.
Check for responsiveness. Shake or tap the child gently. See if the child moves or makes a noise. Shout, "Are you OK?"
If there is no response, shout for help. Send someone to call 911. Do not leave the child yourself to call 911 until you have performed CPR for about one minute.
Carefully place the child on his or her back. If there is a chance the child has a spinal injury, two people are needed to move the child without twisting the head and neck.
Open the airway. Lift up the chin with one hand. At the same time, push down on the forehead with the other hand.
Look, listen, and feel for breathing. Place your ear close to the child's mouth and nose. Watch for chest movement. Feel for breath on your cheek.
If the child is not breathing:
- Cover the child's mouth tightly with your mouth
- Pinch the nose closed
- Keep the chin lifted and head tilted
- Give 2 slow breaths. DO NOT give large, full, forceful breaths.
- If the chest does NOT rise, try the chin lift-head tilt again, and give 2 more breaths. If the chest still doesn't rise, check to see if something is blocking the airway and try to remove it.
Look for signs of circulation -- normal breathing, coughing, or movement. If these signs are absent, begin chest compressions.
Perform chest compressions:
- Place the heel of one hand on the breastbone -- just below the nipples. Make sure your heel is not at the very end of the breastbone.
- Keep your other hand on the child's forehead, keeping the head tilted back.
- Press down on the child's chest so that it compresses about 1/3 to 1/2 the depth of the chest.
- Give 5 chest compressions. Each time, let the chest rise completely. These compressions should be FAST with no pausing. Count the 5 compressions quickly: "a, b, c, d, off."
Give the child 1 slow, full breath. The chest should rise.
- Continue cycles of 5 chest compressions followed by 1 slow, full breath.
- After about 1 minute, check again for signs of circulation.
- At this time, if the child still does not have normal breathing, coughing, or any movement, leave the child to call 911.
- Repeat steps 11 and 12 until the child recovers or help arrives.
If the child starts breathing again, place him or her in the recovery position. Periodically re-check for breathing and signs of circulation until help arrives.