Child health & common illnesses
www.walthamforestccg.nhs.uk
Choking & poisoning

How to resuscitate a child

Cardiopulmonary resuscitation (CPR)

Babies under one year old

  1. Open the baby's airway by placing one hand on the forehead while gently tilting the head back and lifting the chin, keeping the face parallel with the ground. Remove any visible obstructions from the mouth or nose.

  2. Place your mouth over the mouth and nose of the infant and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths.

  3. Place two fingers in the middle of the chest and press down by one-third of the depth of the chest. After 30 chest compressions at a steady rate (slightly faster than one compression a second), give two rescue breaths.

  4. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

Back blows for children under one year

Back blows

  • Support your child in a head-downwards position. Gravity can help dislodge the object.

  • Sit or kneel and support the child on your lap. If this is not possible, support your child in a forward-leaning position and give the back blows from behind.

  • Don’t compress the soft tissues under the jaw as this will make the obstruction worse.

  • Give up to five sharp blows to the back with the heel of one hand in the middle of the back between the shoulder blades.

How to proceed if your child is conscious and under one year, give chest thrusts. If the child is unconscious proceed to CPR.

Chest thrusts for children under one year

  • Support the baby down your arm, which is placed down (or across) your thigh as you sit or kneel.

  • Encircle the chest with your hands putting your two thumbs on the middle of the breastbone.

  • Give five sharp chest thrusts, compressing the chest by about a third of its diameter.

Children over one year old

  1. Open their airway by placing one hand on the forehead and gently tilting their head back and lifting the chin, keeping the face parallel with the ground. Remove any visible obstructions from the mouth or nose.

  2. Pinch their nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths.

  3. Place your hands on the centre of their chest and, with the heel of your hand, press down by one-third of the depth of the chest using one or two hands.

  4. After every 30 chest compressions at a steady rate (slightly faster than one compression a second), give two rescue breaths.

  5. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

Back blows for children over one year

  • Back blows are more effective if the child is positioned head down.

  • Put a small child across your lap as you would a baby.

  • If this is not possible, support your child in a forward-leaning position and give the back blows from behind.

How to proceed if your child is conscious and over one year, give abdominal thrusts. If the child is unconscious proceed to CPR.

Abdominal thrusts for children over one year

Abdominal thrusts

  • Stand or kneel behind the child. Place your arms under the child’s arms and around their upper abdomen.

  • Clench your fist and place it between navel and ribs.

  • Grasp this hand with your other hand and pull sharply inwards and upwards.

  • Repeat up to five times.

  • Make sure you don’t apply pressure to the lower ribcage as this may cause damage.

Following chest or abdominal thrusts, reassess your child:

  • If the object is not dislodged and your child is still conscious, continue the sequence of back blows and either chest thrusts or abdominal thrusts.

  • Call out or send for help.

  • Don’t leave the child at this stage.

Source: NHS Choices, DoH birth to five 2009.