Unconscious Infant Choking

This unconscious infant choking lesson is for situations where you find an infant who is unconscious, and you suspect they became unresponsive due to an airway obstruction.

Ideally, either you or a bystander witnessed the victim choking before they went unconscious. Through further assessment, you find that the infant isn't breathing normally. Any attempts to deliver a rescue breath have failed, most likely due to an obstruction.

In this scenario, you would treat this patient as an unconscious infant choking victim. The method of care will closely resemble performing CPR on an infant, however there are subtle differences to pay attention to.

How to Provide Care

As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy.

• Assess the infant to make sure he or she is not breathing normally and is unconscious.
• Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Then go right into chest compressions.

• Draw an imaginary line across the infant's nipples and place your two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should be wrapping around the infant’s chest. Alternatively, you may also use the heel of one hand in the center of the chest.
• Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on infants, and count as you perform them.
• Conduct 30 chest compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second.
• Grab the rescue mask and seal it over the victim's face and nose.

• If you can, place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position.
• Here’s the difference between CPR and unconscious choking - open the airway and look for the object before giving your two breaths. If you see the object, use your pinky finger to sweep out the object. Never do a finger sweep unless you see the object.
• Place the rescue mask and breathe into the mask and wait for the chest to rise and fall. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions.
• Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths.

• If the rescue breaths go in this time – causing the chest to rise and fall – check for breathing. If after no more than 10 seconds, you do not see, hear, or feel breathing, start CPR.

• >Continue until help arrives, an AED arrives, or the victim is responding positively and breathing normally.