Check for danger to yourself, the infant and anyone else in the area.

If it is safe to do so:

• move the danger out of the way
• move your infant and yourself away.

For example, if your infant becomes unconscious in water, you will take them out of the water to remove the danger.

Use “talk and touch” to check for a response.

1. place one hand on your infant's forehead
2. place your other hand on your infant's shoulder and squeeze gently
3. speak to your infant in a loud, gentle voice.

Do not shake your infant. This can cause serious injury and death.

Your infant may respond by:

• opening their eyes
• making a noise
• moving their body.

If your infant responds, place them on their side. Keep them comfortable while you watch to see how they respond.

If you are worried, see your local doctor or go to your nearest emergency department.

If your infant is not responding, call an ambulance on:

• Triple Zero (000) 
• The international emergency number (112) from digital mobile phones only.

Ask someone nearby to call the ambulance and wait with you if possible.

Put the phone on speaker and follow any instructions.

You must tell the person on the phone that your infant has a tracheostomy and needs CPR.

Check that your infant’s airways are open by:

1. laying them on a firm surface, on their back
2. using your fingers to lift their chin upwards so you can see the tracheostomy tube.

To check the tracheostomy tube, you will need to remove the humidifier and suction out any material that you can see.
You may need to replace the tracheostomy tube to properly remove a blockage.

Check that your infant is breathing by supporting the newly inserted tracheostomy tube and:

• LOOKING to see whether their chest and stomach are moving
• LISTENING for the sound of air coming from the tube
• FEELING whether there is air coming from the tube.

Do this for ten seconds. If your infant is not breathing or is breathing abnormally, you will need to start rescue breaths.
 

1. place your mouth or a resuscitation bag over the tracheostomy tube
2. gently blow or give two breaths 
3. look to see whether your infant's chest is rising and falling with each breath.

If your infant starts to breathe normally after rescue breaths, roll them onto their side and stay with them until the ambulance arrives.
 

If your infant is still not responding or breathing properly, you will need to start CPR with chest compressions.

1. find the centre of your infant's chest, around the lower half of their breastbone
2. place two fingers or one hand, depending on the size of your infant's chest and your strength
3. push your infant's chest down by about 1/3 of its depth, at a fast pace of around 100-120 compressions per minute
4. repeat this 30 times before giving two breaths through the tube, as you did before.

Continue the cycle of 30 pushes and 2 breathes until:

• your infant starts to respond – they move, start to breathe normally, cry or cough
• the ambulance arrives and a paramedic takes over from you.

If your infant starts to respond, roll them onto their side and stay with them until the ambulance arrives.

If you become tired and cannot continue safely, ask another adult close by to take over for a few cycles. 

If you are unable to or prefer not to give breaths, continue to give chest compressions without stopping until the ambulance arrives.

In most cases, it is unlikely that you will need to use a defibrillator or Automated defibrillator on an infant.

Follow instructions over the phone from Triple Zero (000) and continue CPR while you wait for the ambulance to arrive.