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

If it is safe to do so:

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

For example, if your child becomes unconscious in the 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 child's forehead
2. place your other hand on your child's shoulder and squeeze gently
3. speak to your child in a loud but gentle voice.

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

Your child may respond by:

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

If your child responds, place them on their side. Keep them comfortable while you watch them.

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

If your child 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 child has a tracheostomy tube and needs CPR.

Check that your child’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 child 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 child 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 child's chest is rising and falling with each breath.

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

If your child is still not responding or breathing properly, you will need to start CPR.

To perform CPR:

1. place the heel of your hand on the centre of your child's chest, around the lower half of their breastbone
2. place your other hand on top, if your child is older or bigger
3. push your child'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.
5. watch to see the child’s chest rise and fall.

Continue the cycle of 30 pushes and 2 breathes until:

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

If your child 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.

An Automatic External Defibrillator (AED) is a portable device that gives an electric shock to get the heart beating normally again. They are programmed to automatically analyse your child’s heartbeat and give an appropriate shock.

AEDs are commonly found in public places like:

• shopping centres
• airports
• workplaces
• parks
• community centres.

An AED should be used if one is available. Ask a nearby adult to find the closest AED and bring it to you while you stay on the phone with Triple Zero (000) and continue with CPR.

Turn the AED on, switch it to the right setting based on your child’s age and follow the prompts.