Details of the guidelines development process can be found in the Resuscitation Council UK Guidelines Development Process Manual. Identify effectiveness by seeing that the child’s chest has risen and fallen in a similar fashion to the movement produced by a normal breath. Blood gas and electrolyte analysis may be helpful in evaluating CPR effectiveness and identifying underlying causes. 5

Unconscious children and infants who are not in cardiac arrest and clearly have normal breathing, can have their airway kept open by either continued head tilt - chin lift or jaw thrust or, when there is a perceived risk of vomiting, by positioning the unconscious child in a recovery position. Blow steadily into the infant’s mouth and nose over 1 second sufficient to make the chest rise visibly. This is the same time period as in adult practice. Using your body weight (not just your arms), press straight down by 5 to 6cm (2 to 2.5 inches) on their chest. If the child or infant’s coughing is becoming ineffective and or the clinical condition is deteriorating (decreasing consciousness, quiet cough, inability to breathe or vocalise, cyanosis), ask for bystander help and determine the child or infant’s conscious level. A second rescuer should call EMS, preferably by mobile phone (speaker function).

When you call 999 for an ambulance, you should be given basic life-saving instructions over the phone, including advice about CPR. CPR on adults

the involvement of stakeholders from around the world including members of the public and cardiac arrest survivors.

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Electrocardiography (ECG) or Doppler blood pressure measurement to diagnose CPA in unresponsive, apneic patients is not recommended ( III-C) due to the reasons listed above for pulse palpation. 2,5 Send or go for help – call the relevant emergency number on your mobile phone where possible. Only leave the child if no other way of obtaining help is possible. Routine use of IV fluids, magnesium, corticosteroids, or calcium is not recommended ( III-B, IIb-B, III-C, III-B, respectively), but these drugs may be beneficial in specific patient populations. 2,6 Use of these drugs, as well as amiodarone, lidocaine, sodium bicarbonate, reversal agents, and impedance threshold devices are thoroughly covered in the RECOVER guidelines. 2,6