Kneel next to the unconscious person’s upper body. Place one hand on the center of the chest so that the heel of your hand rests on the lower half of the sternum. Then place your other hand on top of it, interlace your fingers and extend your arms through. Be careful not to slip sideways onto your ribs or place your hands too far down, such as on the top of your sternum or stomach.
Now shift your torso forward with your arms outstretched to push your rib cage in – and back again so that it lifts completely. Press the rib cage in between 5 and 6 inches deep with each movement. Repeat this sequence of movements briskly so that you are pushing the chest in about twice per second (per minute 100 to 120 times). Make sure that your arms remain extended at the elbow joint, otherwise you will tire very quickly.
Even if a child is unconscious and no longer breathing normally, the following applies: Do not hesitate with resuscitation! If you proceed in the same way as with an adult, this is better for the child than no resuscitation at all. On the website of the German Red Cross you can learn what to consider when resuscitating children.
Cardiac massage is strenuous. To save strength, you should therefore alternate with someone every two minutes, if possible.
Cardiopulmonary resuscitation in infants and young children
Cardiopulmonary resuscitation is performed whenever unconsciousness and no normal breathing can be detected or there is doubt that normal breathing is present. If two or more rescuers are on scene, tasks can be divided. During cardiopulmonary resuscitation, rescuers should take turns after about two minutes to avoid fatigue.
For infants and children, cardiopulmonary resuscitation should be adapted to the age-related respiratory rhythm, respiratory volume and corresponding heart rate.
Because of the higher risk in children and infants of airway obstruction by foreign bodies, up to five initial rescue breaths should be administered before starting chest compressions. If a rescue breath cannot be administered, only chest compressions are performed.
Cardiac massage for infants and young children
- Undress the infant/toddler as far as absolutely necessary.
- Begin chest compressions if normal breathing is not present after rechecking breathing or if there is any doubt that normal breathing is present.
Special features of the infant
- Place two fingertips of one hand on the center of the infant’s chest (lower third of the sternum).
- Use two fingers to press the sternum down about one-third to one-half (approx. 4 cm) deep.
Special features of the toddler
- Place the ball of one or two hands on the center of the rib cage (lower third of the sternum).
- Bend over the child’s chest and, with an outstretched arm, press the sternum down about one-third to one-half (about 5 cm) deep. Make sure that the fingers do not rest on the chest.
- Completely relieve the sternum after each compression without relinquishing contact between the hand and the child’s chest.
- Press down on the sternum 30 times (frequency: 100- to max. 120 times per minute).
- The duration of pressure and relief should be the same.
Combination cardiac massage with ventilation / rescue breathing for infants and young children
- Administer up to 5 initial breaths before starting chest compressions.
- After 30 chest compressions, reopen the airway and ventilate the infant/toddler.
- Continue the resuscitation measures in the ratio of 30 cardiac pressure massages to two breaths in rapid alternation continuously over a period of one minute.
- Emergency call 112: If the rescuer is alone and the emergency call has not yet been made (by a second rescuer), interrupt resuscitation measures after one minute and make the emergency call.
Special features of the toddler
- If an AED device is nearby, get it or arrange for it.
- Connect the device (if necessary using adhesive child electrodes for children between one and eight years of age) to the affected child and follow the further voice instructions of the AED device.
Continue resuscitation efforts on infant
Then continue resuscitation measures (cardiac massage/breathing) in constant alternation at a 30:2 rhythm until the infant/toddler begins to breathe normally again, the rescue service arrives and continues the measures or the rescuer is exhausted.
Completing cardiopulmonary resuscitation in infants and young children
You can stop cardiopulmonary resuscitation if
- breathing resumes (if unconsciousness persists, the injured infant/infant must be placed in the recovery position, if possible).
- the rescue service arrives and takes over the measures on site without interruption.
- clear signs of life can be detected.
Signs of life can be:
- Normal breathing
- Coughing, swallowing
- Other movement of the affected person