When a child loses consciousness yet continues to breathe, it is a serious medical emergency that demands immediate, decisive action. This specific scenario necessitates a focus on protecting the child’s airway from potential blockage, which is the most immediate threat in an unconscious state. The primary goals are to secure the airway to prevent aspiration and to ensure professional medical services are contacted without delay. Swift intervention using the correct first aid techniques can maintain a stable condition until advanced care arrives.
Assess the Scene and Activate Emergency Services
The first step in any emergency is to confirm the scene is safe for both the child and the rescuer before approaching. Look quickly for hazards such as falling objects, electrical wires, or traffic. Once the area is deemed safe, check the child for responsiveness by gently tapping their shoulder and speaking loudly, avoiding vigorous shaking. If the child does not respond to voice or touch, they are unresponsive, confirming the medical emergency.
Immediately call the local emergency number, or direct a bystander to do so, providing a clear description of the location and the child’s status: “unresponsive but breathing.” It is important to initiate this call for professional help before attempting any physical intervention beyond the initial assessment. The call center operator can provide guidance and will dispatch the necessary medical personnel while you prepare to stabilize the child.
Securing the Airway with the Recovery Position
The most important physical intervention for an unconscious child who is breathing is to place them in the lateral recovery position. This position is designed to prevent the tongue from falling back and blocking the airway, and allows any fluid, such as vomit or secretions, to drain from the mouth. A blocked airway is a life-threatening complication that can occur rapidly when a person’s protective reflexes are suppressed by unconsciousness. The pediatric recovery position is largely the same as for an adult, though with greater care for the child’s size.
To begin, kneel beside the child and ensure both of their legs are straight. Extend the arm nearest to you straight out at a right angle to the body, with the palm facing upward. Next, bring the child’s far arm across their chest and hold the back of that hand against the cheek nearest to you to stabilize the head during the roll. Use your other hand to lift the far leg just above the knee, pulling it up so the foot is flat on the floor.
Keeping the child’s hand pressed against their cheek, gently pull on the bent knee to roll the child toward you, onto their side. The bent leg should rest on the ground and act as a prop to keep the child stable. Ensure the mouth is pointed slightly downward so that gravity assists with drainage. Finally, tilt the head back slightly to ensure the airway remains open, unless a head or neck injury is suspected, in which case movement should be minimized.
Monitoring the Child While Awaiting Help
Once the child is safely in the recovery position, continuous, vigilant monitoring is required until medical help arrives. The child’s breathing pattern must be checked frequently, ideally every 60 seconds, using the “look, listen, and feel” technique. Look for the rise and fall of the chest, listen for breath sounds near the mouth and nose, and feel for the flow of air against your cheek for no more than 10 seconds. This regular check ensures the child has not stopped breathing.
Beyond breathing, observe the child’s skin color and temperature, as these can indicate changes in circulation and overall status. Pale or bluish skin, particularly around the lips or nail beds, may suggest poor oxygenation or circulation. Keep the child covered with a blanket or coat to prevent heat loss, as maintaining a stable body temperature is important. Do not offer the child anything to eat or drink, as their impaired consciousness makes aspiration a high risk.
Actions If Breathing Stops or Consciousness Returns
There are two critical changes in status that require an immediate shift in action while waiting for emergency services. If the child’s breathing stops or becomes abnormal, move them gently onto their back on a firm surface immediately. This prepares them for the initiation of Cardiopulmonary Resuscitation (CPR). If breathing ceases, begin chest compressions and rescue breaths without delay, following age-appropriate protocols for child or infant CPR.
If the child regains consciousness, they may be confused, frightened, or agitated. Keep them as calm and still as possible, and reassure them that help is on the way. Even if they appear to have recovered fully, the underlying medical condition requires a professional medical evaluation. Do not allow the child to stand or walk, as they may be unstable or the cause of the unconsciousness may still pose a risk of relapse.