The importance of the recovery position and how to assess a child's consciousness and breathing.

How to assess a child’s level of consciousness

Use the AVPU scale to assess this.

A: Alertness. Can they answer questions sensibly?

V: Responds to verbal commands

P: responds to Pressure or Pain stimulus

U: Unresponsive to any stimulus

How to open an infant's or child’s airway and check breathing

INFANT

Ensure a neutral position of the head (as an infant’s head is usually flexed when relaxed, this may require some extension) and apply a chin lift.

CHILD

Open the airway using head tilt and chin lift:

Place your hand on their forehead and gently tilt their head back.
With your fingertip(s) under the point of the child’s chin, lift the chin.
Do not push on the soft tissues under the chin, as this may block the airway.
Assess the child's level of consciousness using the AVPU score.

The importance of the recovery position

If an infant or child is not responding to you but breathing normally, it’s safe to put them in the recovery position to maintain an open airway and to prevent them from choking on vomit and other fluids.

How to place an infant or child in the recovery position:

INFANT

If the baby is not responding to you, first perform a primary survey. If this establishes that they are unresponsive but breathing, put them in the recovery position. Cradle the baby in your arms with their head tilted downwards to prevent them from choking or inhaling vomit. Call 999 or 112 for emergency help, and monitor their level of response until help arrives.

CHILD

If you find a child unresponsive, you should conduct a primary survey. If this establishes that they are unresponsive but breathing, put them in the recovery position.

Kneel by the child and straighten their legs. If they are wearing glasses or have any bulky items in their pockets, remove them. Place the arm that is nearest to you at a right angle to their body, with the elbow bent and their palm facing upwards. Bring their other arm across their chest, place the back of their hand against the cheek nearest to you, and hold it there. With your other hand, pull their far knee up so that their foot is flat on the floor.

Keeping the back of the child’s hand pressed against their cheek, pull on the far leg to roll the child towards you and to their side. You can then adjust the top leg so that it is bent at a right angle. You then need to gently tilt the child’s head back and lift their chin to make sure their airway stays open. You can adjust the hand under their cheek to help keep the airway open. Call 999/112 for emergency help if it hasn’t already been done. Monitor their level of response while waiting for help to arrive.

How do I check whether a child is conscious and breathing?

Unii's Paediatric First Aid Journey stresses the importance of the recovery position, as well as assessing consciousness and breathing in an emergency.