An unresponsive child represents a medical emergency requiring immediate action. Unresponsiveness signifies a state where an individual is unconscious and shows no reaction to external stimuli, such as sounds, touch, or pain. This condition can stem from various serious causes, including cardiac arrest, severe injury, or other medical emergencies. Recognizing unresponsiveness swiftly is important for initiating appropriate interventions and seeking professional medical assistance.
Immediate Actions for an Unresponsive Child
When encountering an unresponsive child, ensuring the safety of both the rescuer and the child is the first step. Assess the environment for hazards like traffic, fire, or electrical dangers. Once the scene is safe, confirm unresponsiveness using the “Shout, Tap, Shout” method. For a child, shout their name, then gently tap their shoulder and shout again if there’s no response. For an infant, check responsiveness by gently tapping the soles of their feet while calling out loudly.
If the child remains unresponsive, immediately activate emergency medical services. If another person is present, instruct them to call 911 or your local emergency number and retrieve an automated external defibrillator (AED) if available. If you are alone and the collapse was not witnessed, perform two minutes of cardiopulmonary resuscitation (CPR) before calling emergency services. If the collapse was witnessed, call for help first, then begin CPR.
Checking Pulse on a Child
To assess the pulse on a child, the carotid artery in the neck is the preferred location. Slide two or three fingers into the groove between the windpipe (trachea) and the neck muscles on the side of the child’s neck. Use your index and middle fingers for this assessment, avoiding the thumb, as it has its own pulse that could lead to an inaccurate reading.
Apply gentle pressure until a distinct beat is felt. Check the pulse for a minimum of five seconds but no longer than ten seconds to avoid delaying other interventions. If no pulse is detected within this timeframe, or if there is uncertainty, proceed as if no pulse is present.
Checking Pulse on an Infant
For an infant, typically under one year of age, the brachial pulse on the inside of the upper arm is the preferred site. To locate the brachial artery, position the infant on their back and extend one arm slightly. Place two or three fingers on the inside of the upper arm, between the shoulder and the elbow.
Gently press your fingers into this area to feel for a pulse. As with children, use your index and middle fingers, not your thumb, to avoid confusion from your own pulse. Assess the pulse for at least five seconds but no more than ten seconds, ensuring not to press too firmly, as excessive pressure can obstruct the infant’s delicate pulse.
Next Steps After Pulse Assessment
After assessing the child or infant for a pulse, subsequent actions depend on the findings. If a pulse is present, but the child remains unresponsive and is not breathing normally, or is only gasping, initiate rescue breaths. For children and infants, deliver one breath every three to five seconds, aiming for 12 to 20 breaths per minute. Continue monitoring the pulse every two minutes.
If no pulse is detected, or if there is uncertainty about its presence within the ten-second check, and the child or infant is unresponsive and not breathing normally, start Cardiopulmonary Resuscitation (CPR) immediately. CPR involves chest compressions and rescue breaths, with current guidelines recommending a ratio of 30 compressions to two breaths for a single rescuer. Continue these measures without interruption until professional medical help arrives or the child shows signs of recovery.