Do you know what you have to do when a child collapses or chokes in your presence?

Chances are, you will be as clueless as the next person.

Even if you do know how to perform CPR or cardiopulmonary resuscitation, you should proceed with caution as the emergency procedure for adults differs from that for an infant or small child.

CPR involves a combination of chest compressions using one’s hands and rescue breathing.

Because of their small bodies, you need to be careful where you place your hands, said Dr Nicola Ngiam, a consultant at the University Children's Medical Institute at National University Hospital (NUH).

“Adults usually collapse from cardiac events like a heart attack while children often collapse due to breathing problems. You need to clear the child’s airways,” she said.

When performing CPR on a child under one year of age, you should use two fingers to press his chest.

For a child between one and eight years old, you can use one hand.

Dr Ngiam advises performing CPR until the child recovers or medical professionals arrive on the scene.

When asked why CPR was vital, Dr Ngiam said: “If there’s no oxygen or blood circulation to the child’s brain within four minutes, it will be irreversibly damaged.”

Forget old wives’ tales of dousing food stuck in the throat with vinegar or water.

If a child is choking, parents should not make their child try and force the offending object down with more food or liquid or stick their fingers in his mouth to remove the object.

Instead, they should deliver five sharp blows to the child on his back between his shoulder blades and then turn him around to perform five chest compressions.

Continue until the object is dislodged.

Dr Ngiam added that parents or caregivers should attempt CPR only if they have received relevant training.

“If you are trained in child or infant CPR, the risk of injury to the child is low. If you are untrained and do it the wrong way, it can be dangerous.”

STEP-BY-STEP CPR ON AN INFANT

This should be performed only by those with training.

1. Tap the infant gently on the shoulders to check whether he responds. Call for help and get someone to call 995.

2. Tilt the infant's head upwards and lift his chin to open up his airways.

3. Open the infant's mouth and check if there are any foreign objects lodged in his throat. If you see anything, remove it by sweeping it out with your little finger.

4. Bend close to the infant's mouth and nose to detect signs of breathing.

5. If the infant is not breathing, deliver two breaths over his mouth and nose. Observe his chest for movement.

6. If the infant is lifeless, begin cardiac massage. Place your index finger on the imaginary line between his nipples. Place your middle and ring fingers on the breastbone. Start chest compressions at a rate of 100 per minute. Give the infant two breaths after every 30 compressions. Stop when the infant shows signs of life like crying, moving or coughing or when medical help arrives.

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This article was first published in Mind Your Body, The Straits Times.