Introduction

If an infant does not respond to the sound of your voice or to gentle pressure, it is likely they are unconscious.

In this context, 'infant' refers to a child less than one year old.

Recogntion and treatment

Step 1 of 9: Look for

To confirm if the infant is unconscious and not breathing complete the steps of the primary survey - Danger, Response, Airway, Breathing (DRAB).

Step 2 of 9: Check for danger

Are you or they in any danger?
If you have not already done so make the area safe and then assess them.

Step 3 of 9: Check for a response

• Tap or flick the sole of an infant's foot to try to elicit a response
• Do not shake an infant
• If they respond, refer to the treatment for someone unconscious but breathing - infants
• Shout for help.

Step 4 of 9: Open the airway

• Help them to breath by opening their airway
• To do this, place one hand on the forehead and using one finger lift the chin.

Step 5 of 9: Check breathing

• Position your cheek close to their mouth
• Look, listen and feel for no more than 10 seconds:
  • look to see if the chest is rising and falling
  • listen for breathing
  • feel the breath against your cheek
• If they are not breathing commence cardiopulmonary resuscitation (CPR)

Step 6 of 9: Call for help

• If you have someone with you, send them to dial 999 (or 112) for an ambulance immediately
• If you are on your own carry out CPR for one minute before dialling 999 (or 112) for an ambulance.

Step 7 of 9: Give 5 rescue breaths

• Ensure the airway is open
• Seal your lips around the infant's mouth and nose
• Blow gently into the lungs, looking along the chest as you breathe.
• Fill your cheeks with air and use this amount each time
• As the chest rises, stop blowing and allow it to fall
• Repeat this five times.

Step 8 of 9: Give 30 compressions

• Place the baby on a firm surface
• Locate a position in centre of the chest, it is possible to identify the correct hand position without removing the infant's clothes.
• Using two fingers, press down sharply to a third of the depth of the chest
• Press 30 times, at a rate of 100-120 compressions per minute
• After 30 compressions, give 2 rescue breaths.

Step 9 of 9: Continue CPR

• Continue resuscitation, 30 compressions to 2 rescue breaths
• Do not stop unless:
  • emergency help arrives and takes over
  • they show signs of recovery such as coughing, opening eyes, speaking or moving purposefully and breathing normally
  • you become so exhausted that you cannot carry on.

More information about unconscious not breathing infants

Cardiopulmonary resuscitation (CPR) is a technique whereby oxygen is pumped around the body using a combination of chest compressions and rescue breaths.
Unable, unwilling or untrained to give rescue breaths

Give chest compressions only and continue at a rate of 100-120 per minute (about the speed of the song 'Nelly the Elephant').

Two trained rescuers

Change every two minutes with minimal disruption.

Agonal breathing

This is common in the first few minutes after a sudden cardiac arrest. It usually takes the form of sudden irregular gasps for breath. It should not be mistaken for normal breathing and if it is present chest compressions and rescue breaths (together called cardiopulmonary resuscitation or CPR) should be started without hesitation.