When performing chest compressions on a child proper hand placement is even more crucial than with adults. Place two fingers at the sternum (the bottom of the rib cage where the lower ribs meet) and then put the heel of your other hand directly on top of your fingers (Figure 1).
A child's smaller and more fragile body requires less pressure when performing compressions. The rule to remember is 1 hand, 1 inch. If you feel or hear slight cracking sound, you may be pressing too hard. Apply less pressure as you continue.
1. Proper hand position
Count aloud as you compress five times, followed by one breath. Perform this cycle 20 times - five chest compressions followed by one breath - after which remember to check the victim's carotid artery for pulse as well as any signs of consciousness.
DO NOT FORGET TO DIAL 9-1-1.
If there is no pulse, repeat a complete cycle of 5 compressions/1 breath 20 times before checking for pulse and breathing. If none are present, continue performing CPR until help arrives.
If the child regains an active heartbeat (you detect a pulse) but is still not breathing, rescue breaths at the rate of 1 breath every 3 seconds need to be administered (remember to pinch the nose to prevent air from escaping). After the first rescue breath, count three seconds and if the child does not take a breath on his own, give another rescue breath.