of the throat. Be sure to lift the chin by lifting on the jawbone. Pressure on the soft part of the neck or under the chin may close off the child’s airway.
Step 8. Give 2 rescue breaths. While holding airway open, pinch the child’s nose closed. Cover the child’s mouth with your mouth and create an airtight seal. Blow gently about one second for each breath. Watch for the chest to rise as you give each breath. If the child’s chest did not rise after the first breath, reposition the head using the head- tilt and chin-lift and attempt to give another breath. Proceed to chest compressions after 2 breaths even if breaths failed to cause the chest to rise.
• After you have the blood circulating by doing chest compressions, you need to give the child more oxygen to stay alive. Only blow hard enough to make the child’s chest rise slightly. A slightly bigger child needs a slightly bigger breath. Your mouth must completely cover the child’s mouth while you pinch the child’s nose closed to prevent your breath from escaping.
• Rescue breath is exhaled air, but there is enough oxygen in exhaled air to keep victim oxygenated. If chest doesn’t rise, airway is not open. It could be the head position or something could be obstructing the airway.
Step 9. Do 30 chest compressions. Continue CPR for 2 minutes or a total of 5 sets of 30 chest compressions and 2 rescue breaths. If you know or suspect the child may have choked, check the mouth each time you open the airway to give breaths.
• Don’t take too long to give breaths. Chest compressions should not be interrupted for more than a few seconds.
Step 10. Call 9-1-1 and then continue doing CPR until 9-1-1 arrives and takes over or until the child starts to breathe and move. If the child begins to breathe but is still not responding, roll the child onto his side with head tilted slightly back. Stay with the child and wait for 9-1-1 to arrive. If the child stops breathing, roll the child to his back and resume CPR.
• Call 9-1-1 if child is still not breathing. You need expert help immediately.
Step 11. Call child’s parent after 9-1-1 arrives. • Wait to call child’s parent until help arrives and takes over.
ROLE-PLAY
[Students practice on child manikin.] • Place child manikin on the floor in face-down position for first scenario. Some scenarios will have the child face-down and some face-up. Students will practice each scenario as a group.
• INSIST that students treat manikin like a real child.
• As students practice each scenario, the Instructor should call out each step of child CPR (steps 1-11 listed above).
PAGE 52 | SAFE SITTER® INSTRUCTOR MANUAL UPDATED 2023
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