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Carrying this scenario on, we've found out he's not breathing. So the next thing we need to do is deliver five breaths. In order to get the breaths in, what we need to do is to open up the airway. So the same as we did before, tilt the head back, the head tilt, chin lift. We need to squeeze the nose. The reason we do that is if we're going to blow a breath into the mouth, then we don't want it coming straight back out through the nose.
We're going to squeeze the nose, seal our mouth around their mouths. If you've got a barrier use it, you can use a face shield at this time. However, in this example here you've been out and about and maybe haven't got a first aid kit available to you. What we're going to do is then blow five breaths in. Now, these breaths are just for up to a second, just until we see the chest rising. We're not trying to blow as much air in as possible. It's just to get some air into the lungs to try and stimulate some breathing and also get some oxygen into the system. So, squeeze the nose with the head tilted back and five breaths.
The next thing we need to do is compressions. Now, these are very similar to an adult; however, we don't need to use two hands to push down. With this, we can just use one hand. So what we're doing is, we're pushing down with this part of the hand here, on the heel of the hand, straight in the centre of the chest. And we're pushing down at least one-third of the depth of the chest. Now this, doing it by one third, allows for the different sizes of the child. We're not saying, like with adults, five to six centimetres. Here it's just a judgement call. This is quite a hard amount of pressure you need to push down on. So, hand onto the chest, shoulder straight above, and then the other hand, you can support it on your arm, it doesn't really matter too much what you doing with that, you just need to get these compressions done effectively. So 30 compressions. One, two, three, four, five, 12, 13, 14, 15, 16, 17, 19, 30.
With the compressions, we're pushing down and up with equal amounts. Because what we need to do is we need to force the blood out of the heart, so when we let go, allow the blood to come back in as well. We're doing compressions at a ratio of 100 to 120 per minute. That's nearly two a second. So by pushing down on the chest, we're getting the blood pumping around the body; so the next thing we need to do is the breaths. And this time we're just doing two breaths. So tilt the head back, squeeze the nose.
Two breaths, 30 compressions, and we would carry this on a ratio of 30 compressions to two breaths. Remember we're doing it for one minute, unless help has arrived in that time. If help hasn't arrived, we must go and get help. Now, delivering CPR to a child is gonna be very, very distressing, but you will be okay; you will manage to do it. Afterwards, you're gonna be very upset, understandably upset. But it's so important that you have a go, and you do it. If this child's heart has stopped, which it is in this scenario if you don't do CPR, the chances of survival are very, very low. So we must make sure that we do effective CPR; we shout as loud as we can for help; we get people around to help us. If we're tired we can hand over to a second rescuer, if there's somebody else available there. And when the paramedics do arrive, we give them as much information as possible. How long you've been doing CPR for or any other information about the child. Also when you get to this state, obviously it's very upsetting for people around. And it may well be that you need, in a school like this, you may well need to talk to the other children who might well have witnessed it and also the teachers in this environment.