You arrive on the scene: Check the scene for safety

Check the child for consciousness. Gently tap the shoulder and shout. 

No Response

Call 911 immediately.  

If the child is lying on his stomach, turn him over onto his back. The child should be lying on a hard flat surface.

Check for Breathing and Signs of Life

Watch their chest for any normal movement.  Look for signs of life and breathing for no more than 10 seconds.

No Breathing or Signs of Life

Begin CPR:

1. Position the heel of one hand on the center of the child's chest; place your other hand on top.

2. With your elbows locked and straight, lean over the child’s chest and compress the chest 2 inches in depth 30 times. 

3. After the compressions, give breaths using a resuscitation bag attached to the trach.  Gently squeeze the bag and give 2 breaths – just enough to make the chest rise.

4. Continue with 30 compressions and 2 breaths; 30 compressions and 2 breaths, etc. 

If Breaths Do Not Make Chest Rise

a. Suction the trach tube. If the trach has an inner cannula, remove it and suction the length of the trach tube.

b. Change the trach if it is plugged or dislodged.

c. Give 2 breaths to the trach using a resuscitation bag.

Continue CPR until you see signs of life, another rescuer takes over, or help arrives.