CPR Certification Manual: Ventilations for Infants & Children

Ventilations for Infants & Children

Rescue breaths are particularly important during CPR for children and infants because pediatric cardiac arrest commonly develops from a breathing problem. Each breath should last approximately 1 second and produce visible chest rise.

Infant Head Position: The Sniffing Position

Position an infant's head in a neutral position, sometimes called the "sniffing position" — neither tilted far back nor allowed to flex forward. Over-extending an infant's neck can narrow rather than open the airway, due to differences in infant airway anatomy.

Rescue Breaths for Infants

For an infant:

1. Position the head in a neutral or slightly extended position
2. Create a seal over the infant's mouth and nose with your mouth when practical
3. Give a gentle breath over approximately 1 second
4. Watch for visible chest rise
5. Give a second breath
6. Resume compressions

Use only enough air to cause visible chest rise. Infant lungs are small and require much less air than adult lungs.

Rescue Breaths for Children

For a child:

1. Open the airway using a head-tilt/chin-lift
2. Pinch the nose closed
3. Create a seal over the child's mouth
4. Give 1 breath over approximately 1 second
5. Watch for chest rise
6. Give a second breath
7. Resume compressions immediately

Avoid excessive head extension, especially in smaller children.

Compression-to-Breath Ratio

For single-rescuer CPR:

30 compressions : 2 breaths

Continue cycles of 30:2.

If the Chest Does Not Rise

Reposition the head and ensure that an effective seal has been created. Attempt the second breath, then resume chest compressions. Avoid prolonged interruptions.

If Breaths Cannot Be Given

CPR with breaths is preferred for children and infants. If a rescuer is unable or unwilling to provide rescue breaths, provide continuous chest compressions rather than delaying or withholding CPR.

Special Note: For one rescuer, use 30 compressions to 2 breaths. In BLS, two trained rescuers may use a 15:2 ratio for infants and children.