The first thing to remember about Child CPR is this: in children cardiac arrest is rarely caused by heart failure but rather by an injury such as poisoning, smoke inhalation, or head trauma, which causes the breathing to stop first. And since children are more resilient than adults statistics have shown that they tend to respond to CPR much better if administered as soon as possible.

If the child is unresponsive and you are alone with him, start rescue efforts immediately and perform CPR for at least 1 to 2 minutes before dialing 9-1-1. Before you call an ambulance, immediately check the victim for responsiveness by gently shaking the child and shouting, "Are you okay?" DO NOT shake the child if you suspect he may have suffered a spinal injury.

If the child is clearly unconscious, remember your A-B-C and check the child's airway

"A" is for AIRWAY. A child's breaths may be extremely faint and shallow - look, listen and feel for any signs of breathing. If there are none, the tongue may be obstructing the airway and preventing the child from breathing on his own.

Exercise extra caution when you open the victim's air passage using the head tilt/chin lift technique (Figure 1). This will shift the tongue away from the airway.

If the child is still not breathing after his airway has been cleared, you will have to assist him in breathing

"B" is for BREATHING. If the child remains unresponsive and still not breathing on his own, pinch his nose with your fingertips or cover his mouth and nose with your mouth creating a tight seal, and give two breaths (Figure. 1).

Keep in mind that children's lungs have much smaller capacity than those of adults. When ventilating a child, be sure to use shallower breaths and keep an eye on the victim's chest to prevent stomach distention.

After you've administered the child two breaths and he remains unresponsive (no breathing, coughing or moving), check his circulation

"C" is for CIRCULATION. Check the child's carotid artery for pulse by placing two fingertips and applying slight pressure on his carotid artery for 5 to 10 seconds (Figure 1).

If don't feel a pulse then the victim's heart is not beating, and you will have to perform chest compressions

When performing chest compressions on a child proper hand placement is even more crucial than with adults. Place two fingers at the sternum (the bottom of the rib cage where the lower ribs meet) and then put the heel of your other hand directly on top of your fingers (Figure 1).

A child's smaller and more fragile body requires less pressure when performing compressions. The rule to remember is 1 hand, 1 inch. If you feel or hear slight cracking sound, you may be pressing too hard. Apply less pressure as you continue.