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The following steps are based on instructions from the American Heart Association.
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Check for responsiveness. Shake or tap the child gently. See if the child moves or makes a noise. Shout, "Are you OK?"
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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.
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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.
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Open the airway. Lift up the chin with one hand. At the same time, push down on the forehead with the other hand.
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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.
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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.
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Look for signs of circulation -- normal breathing, coughing, or movement. If these signs are absent, begin chest compressions.
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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."
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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.
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