The child is unresponsive after you tap his shoulders and shout what is the next step

Q: What is the next step when a child is unresponsive?

If youre alone with a child or baby who is unresponsive and not breathing (or only gasping), call 911 after youve done 2 minutes of cardiopulmonary resuscitation (CPR). If someone else is present, shout for the person to call 911 and then have them locate an AED (a defibrillator) right away while you begin CPR.

Medically Reviewed by Dan Brennan, MD on January 18, 2022

Inhaltsverzeichnis Show

1. Check to see if the child is conscious
2. Check breathing
3. Begin chest compressions
4. Do rescue breathing
5. Repeat compressions and rescue breathing if the child is still not breathing
6. Use an AED as soon as one is available
Considerations
When to Contact a Medical Professional
References
Version Info
What is the next step when a child is unresponsive?
What are the first 3 things you must do when you come across and unresponsive child?
What is the first thing you should do if you tap and shout and the victim doesn't respond?
What is the first thing you do when you find an unresponsive patient?

Call 911

If you’re alone with a child or baby who is unresponsive and not breathing (or only gasping), call 911 after you’ve done 2 minutes of cardiopulmonary resuscitation (CPR).
If someone else is present, shout for the person to call 911 and then have them locate an AED (a defibrillator) right away while you begin CPR.
If a child or baby is unconscious but you see regular breathing, call 911 and wait for help. A breathing child or baby does not need CPR, but one that is not breathing or gasping does.

For adult CPR, see Hands-Only CPR for Adults.

This article is a guideline. It is important to learn CPR to know how to do it correctly. For more information about a CPR course, go to redcross.org or heart.org.

1. Check to see if the child is conscious

Make sure you and the child are in safe surroundings.
Tap the child gently.
Shout, “Are you OK?"
Look quickly to see if the child has any injuries, bleeding, or medical problems.

2. Check breathing

Place your ear near the child’s mouth and nose. Is there breath on your cheek? Is the child’s chest moving?

3. Begin chest compressions

If the child doesn’t respond and isn’t breathing:

Carefully place the child on their back. For a baby, be careful not to tilt the head back too far. If you suspect a neck or head injury, roll the baby over, moving their entire body at once.
For a baby, place two fingers on breastbone. For a child, place heel of one hand on center of chest at nipple line. You also can push with one hand on top of the other.
For a child, press down about 2 inches. Make sure not to press on ribs, as they are fragile and prone to fracture.
For a baby, press down about 1 1/2 inches, about 1/3 to 1/2 the depth of chest. Make sure not to press on the end of the breastbone.
Do 30 chest compressions, at the rate of 100 per minute. Let the chest rise completely between pushes.
Check to see if the child has started breathing.
Continue CPR until emergency help arrives.

4. Do rescue breathing

To open the airway, lift the child’s chin up with one hand. At the same time, tilt the head back by pushing down on the forehead with the other hand. Do not tilt the head back if the child is suspected of having a neck or head injury.
For a child, cover their mouth tightly with yours. Pinch the nose closed and give breaths.
For a baby, cover the mouth and nose with your mouth and give breaths.
Give the child two breaths, watching for the chest to rise each time. Each breath should take one second.

5. Repeat compressions and rescue breathing if the child is still not breathing

Two breaths can be given after every 30 chest compressions. If someone else is helping you, you should give 15 compressions, then 2 breaths.
Continue this cycle of 30 compressions and 2 breaths until the child starts breathing or emergency help arrives.
If you are alone with the child and have done 2 minutes of CPR (about 5 cycles of compressions and breathing), call 911 and find an AED.

6. Use an AED as soon as one is available

For children age 9 and under, use a pediatric automated external defibrillator (AED), if available. If a pediatric AED is not available, or for children age 1 and older, use a standard AED.

Turn on the AED.
Wipe the chest dry and attach the pads.
The AED will give you step-by-step instructions.
Continue compressions and follow AED prompts until emergency help arrives or the child starts breathing.

Rescue breathing and chest compressions - child; Resuscitation - cardiopulmonary - child; Cardiopulmonary resuscitation - child

CPR stands for cardiopulmonary resuscitation. It is a lifesaving procedure that is done when a child's breathing or heartbeat has stopped. This may happen after drowning, suffocation, choking, or an injury. CPR involves:

Rescue breathing, which provides oxygen to a child's lungs
Chest compressions, which keep the child's blood circulating

Permanent brain damage or death can occur within minutes if a child's blood flow stops. Therefore, you must continue CPR until the child's heartbeat and breathing return, or trained medical help arrives.

For the purposes of CPR, puberty is defined as breast development in females and the presence of axillary (armpit) hair in males.

1. Check for responsiveness. Shake or tap the child gently. See if the child moves or makes a noise. Shout, Are you OK? 2. If there is no response, shout for help. Send someone to call 911 and retrieve an automated external defibrillator (AED) if one is available. Do not leave the child alone to call 911 and retrieve an AED until you have performed CPR for about 2 minutes. 3. Carefully place the child on their back. If there is a chance the child has a spinal injury, two people should move the child to prevent the head and neck from twisting. 4. Open the airway. Lift up the chin with one hand. At the same time, push down on the forehead with the other hand. 5. Look, listen, and feel for breathing. Place your ear close to the childs mouth and nose. Watch for chest movement. Feel for breath on your cheek.

Considerations

CPR is best done by someone trained in an accredited CPR course. The newest techniques emphasize compression over rescue breathing and airway management, reversing a long-standing practice.

All parents and those who take care of children should learn infant and child CPR if they have not already. See cpr.heart.org/en/course-catalog-search for classes near you.

Time is very important when dealing with an unconscious child who is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur as soon as 4 to 6 minutes later.

Machines called automated external defibrillators (AEDs) can be found in many public places, and are available for home use. These machines have pads or paddles to place on the chest during a life-threatening emergency. They use computers to automatically check the heart rhythm and give a sudden shock if, and only if, that shock is needed to get the heart back into the right rhythm. When using an AED, follow the instructions exactly.

The procedures described in this article are NOT a substitute for CPR training.

Causes

There are many things that cause a child's heartbeat and breathing to stop. Some reasons you may need to do CPR on a child include:

Choking
Drowning
Electrical shock
Excessive bleeding
Head trauma or other serious injury
Poisoning
Suffocation

Symptoms

CPR should be done if the child has any of the following symptoms:

No breathing
No pulse
Unconsciousness

First Aid

1. Check for alertness. Tap the child gently. See if the child moves or makes a noise. Shout, "Are you OK?"

2. If there is no response, shout for help. Tell someone to call 911 or the local emergency number and get an AED if available. Do not leave the child alone until you have done CPR for about 2 minutes.

3. Carefully place the child on its back. If there is a chance the child has a spinal injury, two people should move the child to prevent the head and neck from twisting.

4. 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. You may need to use both hands depending on your size and the size of the child.
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 one third to one half the depth of the chest.
Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be fast and hard with no pausing. Count the 30 compressions quickly: "1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off''.
Rescuers, especially those who are trained in CPR, may also perform chest compressions by the 'two-thumb encircling hands technique.' To do this, encircle the infant's chest with both hands, and compress the chest with both thumbs about one third to one half the depth of the chest.

5. Open the airway. Lift up the chin with one hand. At the same time, tilt the head by pushing down on the forehead with the other hand.

6. 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.

7. 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 two rescue breaths. Each breath should take about a second and make the chest rise.

8. After about 2 minutes of CPR, if the child still does not have normal breathing, coughing, or any movement, leave the child if you are alone and call 911 or the local emergency number. If an AED for children is available, use it now.

9. Repeat rescue breathing and chest compressions until the child recovers or help arrives. Children undergoing CPR should receive two breaths after every 30 chest compressions if there is a single rescuer. They should receive the two breaths after every 15 chest compressions if there are two rescuers.

If the child starts breathing again, place them in the recovery position. Keep checking for breathing until help arrives.

Do Not

If you think the child has a spinal injury, pull the jaw forward without moving the head or neck. DO NOT let the mouth close.
If the child has signs of normal breathing, coughing, or movement, DO NOT begin chest compressions. Doing so may cause the heart to stop beating.
Unless you are a health professional, DO NOT check for a pulse. Only a health care professional is properly trained to check for a pulse.

When to Contact a Medical Professional

If you have help, tell one person to call 911 or the local emergency number while another person begins CPR.
If you are alone, shout loudly for help and begin CPR. After doing CPR for about 2 minutes, if no help has arrived, call 911 or the local emergency number. You may carry the child with you to the nearest phone (unless you suspect a spinal injury).

Prevention

Most children need CPR because of a preventable accident. The following tips may help prevent an accident:

Teach your children the basic principles of family safety.
Teach your child to swim.
Teach your child to watch for cars and how to ride a bike safely.
Make sure you follow the guidelines for using children's car seats.
Teach your child firearm safety. If you have guns in your home, keep them locked in an isolated cabinet.
Teach your child the meaning of "don't touch."

Never underestimate what a child can do. Assume the child can move and pick up things more than you think they can. Think about what the child may get into next, and be ready. Climbing and squirming are to be expected. Always use safety straps on high chairs and strollers.

Choose age-appropriate toys. Do not give small children toys that are heavy or fragile. Inspect toys for small or loose parts, sharp edges, points, loose batteries, and other hazards. Keep toxic chemicals and cleaning solutions safely stored in childproof cabinets.

Create a safe environment and supervise children carefully, particularly around water and near furniture. Electrical outlets, stove tops, and medicine cabinets can be dangerous for small children.

References

American Heart Association. Highlights of the 2020 American Heart Association Guidelines for CPR and ECC. cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf. Accessed April 20, 2021.

Duff JP, Topjian A, Berg MD, et al. 2018 American Heart Association focused update on pediatric advanced life support: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2018;138(23):e731-e739. PMID: 30571264 pubmed.ncbi.nlm.nih.gov/30571264/.

Easter JS, Scott HF. Pediatric resuscitation. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 163.

Rose E. Pediatric respiratory emergencies: upper airway obstruction and infections. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 167.

Topjian AA, Raymond TT, Atkins D, et al; Pediatric Basic and Advanced Life Support Collaborators. Part 4: Pediatric basic and advanced life support: 2020 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16_suppl_2):S469-S523. PMID: 33081526 pubmed.ncbi.nlm.nih.gov/33081526/.

Version Info

Last reviewed on: 2/12/2021

Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 05/23/2022.

What is the next step when a child is unresponsive?

If you're alone with a child or baby who is unresponsive and not breathing (or only gasping), call 911 after you've done 2 minutes of cardiopulmonary resuscitation (CPR). If someone else is present, shout for the person to call 911 and then have them locate an AED (a defibrillator) right away while you begin CPR.

What are the first 3 things you must do when you come across and unresponsive child?

Learn first aid for a child who is unresponsive and breathing.

Check their breathing by tilting their head back and looking and feeling for breaths. Do this for no more than ten seconds. ... .

Move them onto their side and tilt their head back. ... .

Call 999 as soon as possible..

What is the first thing you should do if you tap and shout and the victim doesn't respond?

Overview.

Check for responsiveness. Shake or tap the person gently. ... .

Call 911 if there is no response. Shout for help and send someone to call 911. ... .

Carefully place the person on their back. If there is a chance the person has a spinal injury, two people should move the person to prevent the head and neck from twisting..