How to give CPR to a child
HOW TO GIVE CPR TO A CHILD
17th May 2019, updated on 17th June 2020
Once you've determined that a child is not breathing normally, and CPR is needed,
how do you actually perform CPR safely on a child?
How to determine that a child is not breathing?
Remember, the first step is always to follow DR. ABC, but that's covered in another 'How to guide'.
This 'How to Guide' is created to help remind people of the basics of giving CPR to a child - it is not there to replace proper, face to face training and lots of hands-on practice to learn this vital, life-saving skill. If you'd like to do that, please book yourself on one of our first aid training courses.
For this guide, we're assuming you've already gone through the steps of Danger, Response, Airway, Breathing, Circulation, and the child is really not breathing normally.
What age is a child
In first aid, a child is considered to be between the age of 1 and the onset of puberty.
Before that age, we will treat the child as a baby (also called infant, in first aid). Once they have reached puberty, we treat them as an adult for first aid purposes.
Give five (5) rescue breaths first
There are differences between giving CPR to an adult and a child. First of all, there is a difference between the reason WHY their hearts have stopped. Usually, if an adult goes into cardiac arrest, this is caused by a failure of the heart. Which means there is still oxygen within their blood stream, and once we give CPR, that oxygen will be transported throughout the body, to the cells.
However, a child's (and baby's) heart usually stops because there's been an issue with their breathing. This means that their little body is already short of oxygen, so their cells are desperate for it.
This is why we give infants and children five (5) rescue breaths first, before commencing CPR.
And if we're on our own and need to leave them to make that all-important call to the emergency services, we give them one (1) minute of CPR before we leave them. That is five (5) rescue breaths and then three (3) cycles of 30 compressions to 2 breaths.
Head tilt and chin lift
Before you can give rescue breaths, you need to make sure that the child's airway is open. To do this, put one hand on his/ her forehead. Put one or two fingers of the other hand under his/her chin.. Then, very gently, tilt the child's head up.
This moves the child's tongue away from the back of his/her throat, where it could be blocking the airway.
It is called the 'Head Tilt and Chin Lift'.
Close the nose
If you were to blow into the child's mouth, the air would come out of his/her nose, instead of going to the lungs. This is why we need to close the child's nose first.
We will be keeping our hand on the child's forehead, to keep the airway open. But we are now also going to curl our fingers around to the nose, and close it, so the air can't escape.
Open your own mouth wide, and put it over the child's mouth. Breathe gently into his/her mouth. Make sure you maintain the head tilt and chin lift while you are doing this, and the nose closed, so the tongue doesn't stop the air from going into the lungs, and the air can't escape.
Give the child 5 gentle breaths, and watch his/her chest rise from your peripheral vision. Don't waste time on checking. If you find the chest is not rising, think why this might be - have you opened the airway fully? Are you pinching their nose? Were they choking severely before they collapsed?
Next, we need to give 30 chest compressions.
Make sure you are sitting on your knees, with both knees facing the middle of the child's body. Lean forward so that your shoulders are above the child's chest. Place one hand in the centre of his/her chest.
Keep your elbows locked, do not bend your arms. Your arms become an extension of your shoulders - which in turn, become an extension from your hips. We are using the lever function of the hips to push down on the child's chest, not your arms or shoulders.
Press down hard enough to go to a third of the depth of the chest, which will be about 4 - 5 cm, depending on the child's size. Repeat this 30 times, at a speed of about 100 - 120 per minute.
One easy way of getting the right speed is to count the seconds, saying 'one hundred' press down 'and one' press down, 'one hundred' press down 'and two' press down, 'one hundred' press down 'and three' press down, and so forth, till you get to one hundred and fifteen.
If the child is large, or you are small or do not have enough strength left to use one hand, then you can use two hands on a child. This is the hand position for giving CPR to an adult.
When using two hands, put one hand on top of the other, and interlock the fingers. Place the heel of the hand on the bottom in the centre of the child's chest, and give compressions as you would with one hand.
Full CPR - Cardio Pulmonary Resuscitation
Having given 30 chest compressions, now give the child two (2) rescue breaths. Then continue giving 30 chest compressions and 2 breaths, till medical help arrives and tells you to stop.
Give 1 minute of CPR if on your own
If you're on your own, give the child one minute of CPR before going for help. That is about 3 cycles of 30 compressions to 2 rescue breaths (after having given those 5 initial ones). For an adult, getting help and an AED as soon as possible are absolutely vital; for a child, we give them this one minute of CPR before we get that help and an AED if we're on our own, to oxygenate their cells.