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- Check for response
- If no response i.e. unresponsive and lack of normal breathing i.e. no breathing or gasping
- Activate EMS (Emergency Medical Services or Emergency Response Team) and get or call for an AED (automated external defibrillator), (only if 2 rescuers/persons are present)
- Check for the brachial pulse. Check the pulse for a MAXIMUM of 10 seconds
- If no pulse or pulse less than 60 per minute and signs of poor perfusion then, start compressions
- For one rescuer: Position two fingers in the center of the chest below the nipple line
- Start compressions (1 1/2 inches or at least 1/3 the depth of the chest), doing at least 100 per minute.
- After 30 compressions, open airway – Head tilt-chin lift (push the forehead back with one hand and lift the chin to move the jaw forward with the other hand)
- Use mouth to mouth and nose technique i.e. cover infant's entire mouth and nose with your mouth
- Give 2 breaths, each for a 1-second duration, and look for chest rise. If the first breath doesn't make the chest rise and fall, then reposition the head i.e. head tilt-chin lift, and re administer the breaths. Give one breath, every 3-5 second intervals (12-20 breaths per minute).
- Continue 30 compressions followed by ventilations, i.e. ratio of 30:2, until an advanced airway (i.e., endotracheal tube) is placed, then start continuous chest compressions with ventilations at a rate of 1 breath every 6 to 8 seconds (8 to 10 ventilations per minute).
- Leave to activate emergency medical services and to get an AED after 5 cycles or after 2 minutes (only if 1 rescuer/person is present and the EMS has not been activated)
- If manual defibrillator (2 J/Kg first dose and 4 J/Kg second dose) is not available, an AED with pediatric pads should be used as soon as it is available. Resume chest compressions immediately after the shock is given.
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