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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

If someone has a circulatory arrest, immediate resuscitation is very important. It can be life-saving, for example after a heart attack.

In an emergency in a hospital or doctor’s office, doctors and medical staff can quickly take special measures. Everywhere else, however, immediate first aid by medical laypersons is essential.

In an emergency, the most important thing is to stay calm and adhere to the following regimen:

• Check if the person is unconscious and not breathing normally.
• Call the emergency number 112.
• Start with chest compressions.

If you follow these three steps quickly, you will do everything right. Above all, it is important to start resuscitation immediately! Do not hesitate to do something wrong out of fear.

Good to know: As an untrained layperson, you do not have to ventilate the unconscious person.

If an automated external defibrillator (AED) is available and another person is present, you can supplement resuscitation with this device. However, make sure that you only interrupt chest compressions when the device prompts you to do so.

How do you check if someone is unconscious?

Speak to the person loudly and clearly (for example, „Hello! Can you hear me?“) and gently but firmly shake their shoulder. If the person does not respond, you can assume that he or she is unconscious.

How can you tell if someone is no longer breathing normally?

Drehen Sie die bewusstlose Person auf den Rücken. Fassen Sie ihr unter das Kinn und legen Sie ihr den Kopf in den Nacken, damit die Atemwege frei sind. Sie erkennen einen Atemstillstand daran, dass sich der Brustkorb nicht mehr bewegt und Sie weder ein Atemgeräusch hören noch einen Lufthauch spüren, wenn Sie Ihr Ohr nah über Mund und Nase der bewusstlosen Person halten.

In den ersten Minuten nach einem Kreislaufstillstand kann es sein, dass die betroffene Person noch atmet – ihre Atemzüge sind dann jedoch nicht normal, sondern

• irregularly,
• particularly slow,
• particularly deep or
• associated with a snoring-like sound.

Do not under any circumstances wait until breathing stops completely. If after ten seconds you still have doubts as to whether the unconscious person is breathing normally, you should make the emergency call and start resuscitation.

What should be considered when making an emergency call?

If there are other people present besides you, speak to someone directly and ask him or her to take over the emergency call. Then you can start resuscitation immediately.

If you are alone, call 112 yourself. This emergency number is available throughout Europe, is free of charge and can also be used in many countries outside Europe.

The employee at the emergency call center will ask you the following five „W questions“. Answer all the questions calmly and accurately:

• Where did it happen?

Specify the location as accurately as possible (for example, address, floor, street mileage).

• Who is calling?

Include your name, location, and phone number for possible questions.

• What happened?

Describe concisely what they see that happened (for example, traffic accident, fire, unconscious person).

• How many people are involved?

If possible, indicate the number of people involved and their injuries. For children, also the age if possible.

• Waiting for further inquiries!

Legen Sie nicht sofort auf. Ihr Gegenüber in der Leitstelle benötigt vielleicht noch mehr Informationen.

Wenn möglich, schalten Sie den Lautsprecher ihres Telefons ein („Freisprechen“) und bleiben mit der Notrufzentrale in Verbindung. So kann das Personal der Notrufzentrale Sie telefonisch bei der Wiederbelebung unterstützen.