When to Call 911 First
If you encounter an unresponsive child in or near water, your first action is usually to call 911 immediately.
Call 911 Immediately If:
- Child is unresponsive or unconscious
- Child is not breathing normally (gasping is not normal breathing)
- Child pulled from water and appears to be drowning
- You're unsure about the severity (when in doubt, call)
Exception: If you're alone with a child who is unresponsive, provide CPR for 2 minutes first (about 5 cycles of compression-rescue breath), then call 911 if possible. If a second person is present, one should call while the other begins CPR.
CPR for Children Ages 1-8
CPR for children differs slightly from adult CPR. These are the basic steps:
Make sure the scene is safe (no danger to you) and the child is on a firm, flat surface. If in water, get the child out first.
Tap the child on the shoulders and shout "Are you okay?" Look for any response—movement, sounds, or opening eyes.
Look for normal chest rise, listen for breath sounds, feel for breath on your cheek. You have about 10 seconds. Important: Gasping is NOT normal breathing. If you see gasping or no breathing, begin CPR.
For ages 1-8: Place the heel of one hand on the center of the chest (between the nipples). For very small children, you can use two fingers instead. Keep the other hand on the forehead to maintain airway position.
- Depth: Push hard and fast, compressing the chest at least 2 inches deep
- Rate: 100-120 compressions per minute (roughly the beat of the song "Stayin' Alive")
- Release: Let the chest recoil completely between compressions
Push hard. Many people don't push hard enough. Breaking a rib is not your primary concern—the child is already not breathing.
- After 30 compressions, open the airway by tilting the head back slightly and lifting the chin
- Pinch the child's nose closed
- Seal your mouth over the child's mouth
- Give 2 gentle breaths—watch for chest rise but don't overfill
- Return to compressions immediately
Note: If you're uncomfortable giving rescue breaths, compression-only CPR (just pushing on the chest) is also effective and recommended.
Continue CPR (30 compressions + 2 breaths, repeat) until:
- Emergency responders arrive and take over
- The child shows signs of life (coughing, moving, opening eyes)
- You're too exhausted to continue safely
Do NOT stop CPR to check if they're breathing unless emergency services have arrived.
CPR for Infants (Ages 0-1)
CPR for infants is slightly different due to their smaller size:
- Hand position: Use 2-3 fingers (index and middle finger) instead of the heel of your hand
- Compression depth: At least 1.5 inches (about 1/3 the depth of the chest)
- Rate: 100-120 compressions per minute (same as older children)
- Rescue breaths: Give gentle breaths—your mouth covers both the nose and mouth of the infant
Recovery Position
If a child is breathing and responsive but still unconscious, place them in the recovery position to keep the airway open:
- Turn the child on their side
- Tilt the head back slightly to open the airway
- Place one arm under the head for support
- Bend one leg to prevent rolling
- Monitor breathing continuously
Never leave a child in the recovery position alone. Stay until emergency responders arrive.
Common CPR Mistakes
These are mistakes people commonly make during CPR:
- Not pushing hard enough: Compressions should be vigorous and deep. The child is already not breathing—you can't make it worse.
- Pushing too slowly: 100-120 compressions per minute. Faster is better than slower.
- Stopping to check for responsiveness: Once you start CPR, continue until responders arrive. Only stop for rescue breaths.
- Not opening the airway: Tilt the head back to open the airway for rescue breaths.
- Giving up too quickly: CPR should continue for several minutes. A child's heart can restart after many minutes without oxygen.
After Emergency Services Arrive
When 911 responders arrive:
- Explain what happened (pulled from water, found unresponsive, etc.)
- Tell them how long CPR was performed
- Describe any medications or treatments given
- Step back and let professionals take over
- Provide contact information for parents/guardians
Drowning Doesn't End at the Hospital
"Dry drowning" or "secondary drowning" can occur hours after a water incident. Symptoms include:
- Difficulty breathing or shortness of breath hours later
- Chest pain or coughing
- Lethargy or behavioral changes
- Fever
- Vomiting
If a child has been rescued from water, monitor them closely for 24 hours and seek medical attention immediately if any of these symptoms appear. For a complete guide to what to do in the critical moments of a water emergency, read our article on what to do if you see someone drowning.
Getting Certified: Why It Matters
This article provides basic information, but hands-on training is essential. Certification courses include:
- Supervised practice on CPR mannequins
- Feedback on compression depth and rate
- Practice giving rescue breaths
- Scenario training (real-world situations)
- Official certification card upon completion
Recommended certifications: American Red Cross, American Heart Association, or equivalent recognized organization.