After delivery 1 shock you immediately resume cpr with what ratio of compressions to breaths

Performing CPR is always a high-stakes exercise. But when you’re performing CPR on your infant child, or an infant you’re caring for, the stakes somehow feel even higher. A life-or-death situation with a small, fragile infant is a position that no one wants to be in, but it’s important to be prepared, should such a situation ever arise.

So how can you be prepared? Learning the basics of CPR for infants is a good place to start. Yes, CPR for infants is slightly different than CPR for children or for adults, and the distinctions are important to know.

One of the most common questions asked about CPR for infants is about the CPR “ratio.”

What is a CPR ratio?

The term CPR ratio refers to the ratio of chest compressions to rescue breaths when performing CPR. In other words, how many compressions should you give for every breath in order to optimize the oxygenated blood that’s being manually pushed through the cardiovascular system and ultimately into the brain. In the CPR world, there are very specific guidelines to this, especially with infants.

What is the CPR ratio for an infant child?

The CPR ratio for an infant child is actually the same as the ratio for adults and children, which is 30:2. That is, when performing CPR on an infant, you perform 30 chest compressions followed by 2 rescue breaths. According the the American Heart Association and ILCOR, it is certainly permissible to perform “hands only” CPR on adults and older children. But for infants, it’s absolutely recommended to weave in the two breaths every 30 compressions.

How do I perform chest compressions on an infant?

Chest compressions on an infant are performed differently than chest compressions on an adult or child. Because an infant is more fragile, the compressions should be performed with only two fingers, at the center of the chest, just below the nipples. Compressions should be about an inch and a half deep and at a rate that coincides with the beat of the song “Staying Alive” by the Bee Gees.

How do I perform rescue breaths on an infant?

Performing rescue breaths on an infant is quite different than performing them on adults, or even on older children.

For adults and children aged one or older, you should pinch the nose shut with your fingers while covering the victim’s mouth with your own to perform rescue breaths. This is not possible to do effectively with an infant. Because of this, when performing rescue breaths on an infant, you should cover the infant’s mouth and nose with your mouth, creating a tight seal.

There are a couple other important differences concerning rescue breaths for infants.

One is the angle of the head. Any victim’s head should be tilted slightly backwards before performing rescue breaths, so as to open the airway. However, it’s important to not tilt the head back too far, and it’s very easy to overdo it with an infant. Because of this, many people recommend tilting the baby’s head back very slightly in a “sniffing position,” just back far enough so that it looks like the infant is sniffing the air. This gets the baby’s head at the right angle.

Another big difference is the power of the breath. A full adult breath would be too much for an infant, so instead of using your lungs to administer the breath, it’s recommended to just fill your cheeks with air and use that breath as the rescue breath.

What should I do after I perform chest compressions and rescue breaths?

CPR should only be performed if the infant is unconscious or unresponsive. If the infant regains consciousness, stop performing CPR and call 911. Stay with the infant, monitoring them closely, until help arrives.

If the infant does not regain consciousness, perform 5 cycles of CPR (i.e. 30 compressions and 2 rescue breaths, repeated 5 times) and then call 911. After you have called for help, continue performing CPR until emergency services arrive.

(Note: for infants and children, immediate CPR is vital. If you are alone with the infant, perform at least 5 cycles of CPR before pausing to call 911. If you are not alone with the infant, one person should call 911 immediately while the other begins CPR.)

Remember this: the purpose of CPR is not to bring a child back to consciousness, but to manually perform the work of the cardiovascular system until advanced medical help arrives.

How can I remember the CPR ratio for an infant child?

The best way to learn and retain all proper CPR techniques is to take a CPR certification course, and review the course materials often to keep the information fresh in your mind.

Infant CPR offers online certification courses that are convenient and comprehensive, so you can receive quality CPR training from the comfort of your home. Once you’ve enrolled in one of our courses, you have unlimited access to the material, so you can refer to it any time you need to brush up on your skills.

Learning how to properly perform CPR on infants can increase your confidence as a parent or caregiver. Try one of our classes today!

Call triple zero (000) for an ambulance in an emergency to get medical assistance. Common emergency situations for adults and children include:

Calling triple zero (000)

Some people hesitate in calling triple zero because they don’t believe their situation qualifies as an emergency. If in doubt, call 000 – the operator will direct you to the help you need.

Emergency phone operators are trained to help you and can provide advice about what you need to do while you're waiting for emergency services to arrive.

What to expect during your call to triple zero (000) – ambulance

When you call triple zero (000), you will be asked which service you require. Tell the operator you need an ambulance. You will then be transferred to an ambulance operator and asked for the following information:

• The location you need the ambulance to respond to. If the address if known, provide this to the operator.
• If the address is not known, be sure to tell the operator any additional information that may assist. This may include street or road names, parks, emergency marker details , or any other landmarks nearby.
• Details of the situation and what has happened.
• How many people require medical assistance.
• The injured person’s age and sex.
• Whether the person is conscious or breathing.

The operator will organise assistance for you while you continue talking on the phone, even though you may not hear them do this.

Answer any of the operator’s questions as this can help the paramedics prepare their response before the ambulance reaches you.

The operator may give you first aid instructions over the phone. If you can, put your phone on loudspeaker.

Do not hang up until the phone operator tells you to.

When is CPR needed?

CPR is most successful when administered as soon as possible. CPR is required when a person is:

• unconscious
• not breathing normally
• not breathing.

A person in cardiac arrest may grunt, snort or take gasping breaths – this is not normal breathing. They still need CPR – don’t wait until they stop breathing.

Although CPR steps are the same for adults and older children, the technique for babies and young children (0-5 years) is slightly different.

DRSABCD (or ‘doctors ABCD’)

The steps involved in CPR are known as DRSABCD:

D – Danger R – Response S – Send for help A – Airway B – Breathing C – CPR

D – Defibrillator

You may like to call it ‘doctors ABCD’ (DRS ABCD) so you can remember each step.

Steps before giving CPR to babies and young children

1. D= Danger – look for the source of any danger and make sure you and your child are safe.
2. R= Response – check for a response from your child as if you are trying to wake them up. For instance, speak loudly, gently squeeze them or tickle their feet.
3. S = Send for help if your child is not responding. Call 000 and ask for an ambulance. Don’t leave your child unattended.

The emergency services operator will guide you through CPR until the ambulance arrives.

How to give CPR to babies 0-12 months

This video is available in a version aimed at Aboriginal communities , and also in the following languages:

Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes.

To perform CPR on infants (0-12 months):

1. A=Airways – check your baby’s airways (nose, mouth and throat) are clear. Remove any blockage (such as vomit, blood, food or loose teeth).
2. Make sure your baby is in a neutral position (such as on their back) with their head and neck in line. Do not tilt their head back or lift their chin.
3. B=Breathing – is your child breathing normally? If so, gently roll them onto their side (known as the recovery position).
4. If they are not breathing or breathing abnormally (such as grunting or gasping for air) you will need to perform CPR.
5. C=CPR consists of 2 techniques – 30 chest compressions and 2 breaths of mouth-to-mouth.

Chest compression steps

1. Lie your baby on their back.
2. Place 2 fingers on the lower half of your baby’s breastbone (in the middle of their chest).
3. Press down with your fingers (or palm for babies over 6 months) to about a third of the depth of their chest, then release to the rest position.
4. This counts as one compression.

Note: You may need to use the palm of your hand instead of your fingers depending on the size of your baby.

Mouth-to-mouth on babies (0-12 months)

1. Make sure your baby is resting in the neutral position and that their head and neck is not tilted.
2. Gently lift their chin – be careful not to rest your hands on their throat as this could restrict air getting into their lungs.
3. Take a small breath and cover your baby’s nose and mouth Blow gently for about one second watching for the chest to rise.
4. After each breath watch for your baby’s chest to fall. Place your ear and face close to your baby’s ear and nose to see if air is being expelled.
5. If your baby’s chest is not rising, gently check again for any blockages and remove them.
6. Continue to give 30 chest compressions, followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes.

Keep going until:

• Your baby recovers (they start to move, breathe normally, cough or cry). Then put them in the recovery position (onto their side).
• The ambulance arrives and the paramedics take over.

Remember, if you are finding it difficult to keep up mouth-to-mouth breathing, keep going with compressions – they can still save your baby’s life.

How to give CPR to young children 1-5 years

This video is also available in the following languages:

Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes.

To perform CPR on children (1-5 years):

1. A=Airways – check your baby’s airways (nose, mouth and throat) are clear. Remove any blockage (such as vomit, blood, food or loose teeth).
2. Make sure your child is in a neutral position (such as on their back). Gently tilt their head back and lift their chin.
3. B=Breathing – is your child breathing normally? If so, gently roll them onto their side (known as the recovery position).
4. If they are not breathing or breathing abnormally (such as grunting or gasping for air) you will need to perform CPR.
5. C=CPR consists of 2 techniques – 30 chest compressions and 2 breaths of mouth-to-mouth.

Chest compression steps

1. Lie your child on their back. Kneel beside them.
2. Place the heel of one hand on the lower half of your child’s breastbone (in the middle of their chest).
3. Position yourself above your child’s chest.
4. Keep your arm straight and press down on their chest to a third in depth, then release the pressure.

This counts as one compression.

Mouth-to-mouth on children (1-5 years)

1. Open your child’s airway by gently placing one hand on their forehead and the other hand on their chin to tilt their head back.
2. Pinch the soft part of their nose closed with your index finger and thumb.
3. With your other hand, open their mouth with your thumbs and fingers.
4. Take a breath and place your lips over your child’s mouth. Ensure you have a good seal so no air can escape.
5. Blow steadily for about one second, watching for the chest to rise.
6. After each breath watch for their chest to fall. Listen and feel for signs that air is being expelled.
7. Maintain the chin lift and tilt position – take another breath and repeat.
8. If your child’s chest is not rising, check again for any blockages and remove them. Then keep going with mouth-to mouth, making sure their head is lifted, chin tilted. Ensure that no air is escaping.
9. Continue to give 30 chest compressions, followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes.

Keep going until:

• Your child recovers (they start to move, breathe normally, cough or talk). Then put them in the recovery position (onto their side).
• The ambulance arrives and the paramedics take over.

D= Defibrillator – CPR must be continued until an automated external defibrillator (AED) becomes available, the pads are attached and the machine is turned on.

Remember, if you are finding it difficult to keep up mouth-to-mouth breathing, keep going with compressions – they can still save your child’s life.

How to give CPR to adults and older children

Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes.

If you can’t do mouth-to-mouth, stick with continuous compressions at a rate of approximately 100 per minute.

To perform CPR on adults and older children:

1. A=Airways – open the person’s airways (nose, mouth and throat) and check they are clear. Remove any blockage (such as vomit, blood, food or loose teeth). Don’t spend too much time doing this – CPR is your main priority.
2. Make sure the person is in a neutral position (such as on their back). Gently tilt their head back and lift their chin.
3. B=Breathing – are they breathing normally? If so, gently roll them onto their side (known as the recovery position).
4. If they are not breathing or breathing abnormally (such as grunting or gasping for air) you will need to give them CPR.
5. C=CPR consists of 2 techniques – 30 chest compressions and 2 breaths of mouth-to-mouth.

Chest compression steps

Place the heel of one hand on the lower half of the person’s breastbone (in the middle of their chest).

1. Place your other hand on top of your bottom hand and grasp your wrist. Or you may like to interlock your fingers – depending on what feels comfortable.
2. Keep your arms straight and press down on their chest by one third of their chest depth.
3. Release the pressure – this counts as one compression.

Popular tunes can help keep the rhythm of compressions

To keep the correct rhythm of compressions, you may like to use these popular songs:

• ‘Staying alive’ by the Bee Gees
• ‘Row, row, row, your boat’
• ‘Baby shark’.

Mouth-to-mouth on adults and older children

1. If the person is not breathing normally, make sure they are lying on their back on a firm surface.
2. Open the airway by tilting the head back and lifting their chin.
3. Close their nostrils with your finger and thumb.
4. Put your mouth over the person’s mouth and blow into their mouth. Make sure no air is leaking.
5. Give 2 full breaths to the person (this is called ‘rescue breathing’).
6. Check their chest is rising and falling. If this is not happening, tilt their head back, pinch their nostrils tightly and seal your mouth to theirs.
7. If still no luck, check their airway for any obstruction.
8. If you cannot get air into their lungs, go back to chest compressions – this may help shift an obstruction.
9. Continue to give 30 chest compressions, followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes.

Keep going until:

• The person becomes responsive. They may begin to move, breathe normally, cough or talk. Then put them in the recovery position (onto their side).
• The ambulance arrives and the paramedics take over.

CPR can be tiring. If you need a break, ask someone else to assist with minimal disruption. Rotate the person performing compressions every 2 minutes.

If you find mouth-to-mouth difficult, continue with chest compressions until medical help arrives. They can still save someone’s life.

Can it be dangerous doing chest compressions?

Sometimes, people will have their ribs broken by chest compressions. This is still better than the alternative of not receiving CPR.
If this occurs, pause and reposition your hands before continuing or get someone else to take over.

Automated external defibrillators (AED)

D= Defibrillator – A defibrillator is a life-saving device that treats someone who is having a cardiac arrest. It can analyse abnormal heart rhythms and send an electric shock or pulse to get the heart to return to its normal pumping rhythm.

CPR must be continued until an automated external defibrillator (AED) becomes available. The pads must be attached to the skin and the machine turned on.

AEDs are easy to use – voice prompts tell you what to do.

There are different types of AEDs and some are available in public places (such as shopping centres and schools).

It is important to follow the prompts on the AED. Do not touch the person during analysis or shock delivery.

If there is an emergency, knowing simple first aid can mean the difference between life and death. Consider taking a first aid course. CPR can be life-saving first aid – it increases someone’s chances of survival until an ambulance arrives.

First aid training courses are available across Australia. A course typically takes a couple of hours and can be taken online or in person. Times are also flexible.

Participants learn basic first aid skills (including CPR) and usually receive a certificate. Follow up refresher courses are recommended every 3 years.

Many organisations hold regular courses, ask your doctor or maternal and child health nurse for more information.

Where to get help

• Australian Resuscitation Council (ARC) Guidelines , Australian Resuscitation Council
• Guideline 8, Cardiopulmonary Resuscitation , 2021, Australian Resuscitation Council and New Zealand Resuscitation Council
• DRSABCD Action Plan: First Aid Fact Sheet (PDF) ,  St John Ambulance Australia
• Sayre MR, Berg RA, Cave DM, et al. 2008, ‘Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest’ , Circulation, vol. 117, pp. 2162-2167
• White L, Rogers J, Bloomingdale M, et al. 2010, ‘Dispatcher-assisted cardiopulmonary resuscitation: risks for patients not in cardiac arrest’ , Circulation, vol. 121, pp. 91-97
• Matlock D, Hafner JW, Jr, Bockewitz EG, et al. 2008, 83: "Stayin’ Alive”: a pilot study to test the effectiveness of a novel mental metronome in maintaining appropriate compression rates in simulated cardiac arrest scenarios , Annals of Emergency Medicine, vol. 52, no. 4, pp. S67-68
• Victorian Ambulance Cardiac Arrest Registry (VACAR) Annual Report , Ambulance Victoria

This page has been produced in consultation with and approved by:

This page has been produced in consultation with and approved by:

This page has been produced in consultation with and approved by:

Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.