Initial CPR Steps (When to Start C-A-B)

Overview (Quick Review):

  • Assess the victim for response. If there is no response, shout for help!
  • Activate the emergency response system (911) and get an AED (defibrillator) if available, then return to the victim.
  • Look for normal breathing (no longer than 10 seconds).
  • If the victim is not breathing or is only gasping, start your chest compressions and breaths (C-A-B sequence).

Knowing when to begin infant CPR steps or adult CPR can be the difference between life and death in an emergency.

Assess

WARNING!

If you are the first responder on the scene, make sure the scene is safe. Do not allow yourself to become injured as well. If the scene is not safe, stay away and activate the emergency response system (911). If you feel the victim is in a dangerous environment where more harm may occur, you can move them out of the scene if it is safe for you to do so.

  • Make sure the scene is safe for you and the victim.
  • Tap the victim on the collarbones and shout “ARE YOU OKAY?”
  • Check to see if the victim is breathing normally.

If the victim does not wake up, activate the emergency response system (911). If the victim is not breathing, activate the emergency response system (911). If the victim is not breathing normally or only gasping, activate the emergency response system (911). A snort, snore, or groan is not normal breathing. This is a sign of cardiac arrest. Activate the emergency response system (911).

Emergency Response System

People Around

If you find an unresponsive victim and you think there are other people around, shout “HELP!”. When another responder arrives, tell them to activate the emergency response system (911) and get an AED (defibrillator) if available.

Alone (Cell Phone)

If you are alone and find an unresponsive victim and you have your cell phone, activate the emergency response system (911), set the phone down (if possible turn on speakerphone), check the victim for breathing, and begin your C-A-B sequence.

Alone (No Cell Phone)

If you find an unresponsive victim, are alone, and think you can get help within 2 minutes, leave, activate the emergency response system (phone, cell phone, or person), grab the AED (if available), return to the victim, and begin your C-A-B sequence.

WARNING!

If getting help will take longer than 2 minutes, activate the emergency response system, but DO NOT leave. Check for breathing and begin your C-A-B sequence. Perform 5 cycles of compressions and breaths FIRST before leaving.

WARNING!

If the victim is a child or infant, DO NOT leave! Check for breathing and begin your C-A-B sequence. Perform 5 cycles of compressions and breaths FIRST before leaving.

Look for Breathing (Infant)

Look for breathing for no longer than 10 seconds. You do this by looking for “chest rise and fall,” which may look more like stomach rise and fall in an infant. If you do not see the victim breathing, or if they are only gasping, try to remove clothing from the chest and begin CPR.

WARNING!

Chest compressions, if needed, are always started within 10 seconds after activating the emergency response system or calling 911. You should take no more than 10 seconds to check for breathing.

WARNING!

It can be difficult to determine the presence or absence of breathing. If there is any doubt whether the victim is breathing normally or only gasping, START CPR. Starting chest compressions on someone who was breathing will not harm them, and hopefully, the victim will respond.

Infant Chest Compressions (1 Rescuer)

Infant (Birth – 1 year of age)

  • Depth: 1.5 inches (About 4 cm)
  • Rate: 100–120/min
  • Compressions: 30
  • Technique: Two fingers

Place fingers below the nipples, on the center of the chest.

Infant Chest Compressions

  • Place the infant on a firm, flat surface.
  • Position yourself at the infant’s side.
  • Place 2 fingers in the center of the infant’s chest just below the nipple line. Do not press on the bottom of the breastbone.

You can’t measure inches while performing compressions, so compress until you feel resistance. The biggest mistake is shallow compressions due to fear of injury. Remember: deep compressions = more blood flow!

  • Push hard and fast. Press straight down on the infant’s breastbone.
  • After each compression, allow the chest to fully recoil for maximum circulation.
  • Perform 30 chest compressions with minimal interruptions.

Airway

Key Notes:

  • A victim’s airway must remain open to breathe.
  • Opening and maintaining an open airway allows air from breaths to enter the lungs.
  • Head-tilt-chin lift is the preferred method to open an airway.

Infant Head-Tilt-Chin Lift

  • Place one hand on the forehead and tilt the head back.
  • Place fthe ingers of the other hand under the bony part of the chin.
  • Lift the chin to bring the jaw forward.

WARNING!

Do not place fingers into the soft tissue under the chin—only use the bony part.

WARNING!

Do not lift an infant’s head beyond the neutral position. Hyperextending the airway can cause it to become blocked.

Breathing (Breaths)

Key Notes:

  • Only give 2 breaths or two attempts. If both fail, return to chest compressions.
  • If both fail, the airway may be obstructed. Chest compressions may help dislodge the object.
  • Never perform a blind finger sweep. Remove only visible obstructions.
  • Watch for chest rise—it signals effective breath.
  • Infants have small lungs, so a small puff of air may be enough.

If no barrier device is available and you feel unsafe, perform compression-only CPR. Once a device is available, begin giving breaths.

WARNING!

Breaths that are too quick or strong can inflate the stomach and cause vomiting.

Mouth-to-Mouth

WARNING!

Mouth-to-mouth may pose a health risk. Compression-only CPR is always acceptable if no barrier device is available.

  • Position yourself at the victim’s side.
  • Open the airway (head-tilt-chin lift).
  • Pinch the nose closed and seal your mouth over the victim’s.
  • Give one slow breath. Watch for chest rise and stop once it rises.
  • If unsuccessful, reposition and try again.
  • Regardless of success, return immediately to compressions.

Infant Mouth-to-Mouth

Place your mouth over the infant’s mouth and nose to form an airtight seal.
Blow gently into both until the chest rises.

WARNING!

Only use the air that fills your cheeks—small puffs are all that’s needed for infant CPR steps.

Mouth-to-Mask (Barrier Device)

If a barrier device is available, always use it for breaths. Masks have one-way valves to protect the rescuer.

  • Position yourself at the victim’s side.
  • Place the mask securely on the face, top at the nose bridge.
  • Seal the mask using one hand on top, thumb and index finger sealing the edges.
  • Use your second hand to press the mask’s bottom and lift the jaw.
  • Open the airway with a head-tilt-chin lift.
  • Give one slow breath and watch for chest rise.
  • Reposition if the chest doesn’t rise. Then give a second breath.
  • Return immediately to compressions.

Be Prepared to Act: Learn Infant CPR Steps Today

Emergencies can happen at any moment, and knowing how to respond with proper infant CPR steps can save a life. Whether you’re a parent, caregiver, or healthcare provider, mastering these steps gives you the confidence to act fast when every second counts.

Want to be ready to respond? Start your CPR training today with Health Solutions of America. Our nationally recognized, online certification makes learning easy and accessible—no classroom required. Contact us to enroll and ensure you’re prepared to help when it matters most.