Editing Choking (section)

===== Unconscious infants =====
An ''unconscious'' infant has to be placed face-up on a firm and horizontal surface (as the floor). The baby's head must be in a straight position, facing frontally, because tilting it too much backwards can close the access to the trachea in infants.

A rescuer can then ask for any of the known anti-choking devices, and try it on the unconscious baby. There can be difficulties because of the little size of the infant. The obstruction can be dislodged, but remaining into the mouth, which would need a manual removal. If the baby cannot breath then, or stays in a cardiac arrest, the rescuer must perform a normal cardiopulmonary resuscitation (CPR), as it is described below, but only alternating the 30 compressions and the 2 rescue breaths.

[[List of emergency telephone numbers|Emergency medical services]] must be called, if this has not been done yet.

It can be also convenient that any rescuer asks for a defibrillator near (an AED, as those devices are very common today), just in case it is necessary to treat the baby's heart.

Until emergency services arrive, the American Heart Association<ref name=":4" /> recommends starting (even<ref name=":9" /><ref name=":11" /> with no more delay) an anti-choking cardiopulmonary resuscitation (CPR) adaptive to infants less than one year old (described below). It is a cycle of resuscitation<ref>{{Cite book |last=American Red Cross |title=CPR/AED and First Aid |pages=33 |chapter=Choking – Special Situations}}</ref> that alternates compressions and rescue breaths, like in a normal CPR, but with some differences: 
The rescuer begins by making 30 ''compressions,'' pressing with only two fingers on the lower half of the bone that crosses the middle of the chest from the neck to the belly (on the chest bone, named [[sternum]], on its part that is the nearest to the belly), at an approximate rhythm of nearly 2 per second.

At the end of the round of compressions, the rescuer looks into the mouth for the obstructing object. And, if it is already visible, the rescuer makes a ''try to extract it'' (usually using a finger sweep). The rescuer must not confuse a foreign object with the epiglottis: a cartilaginous flap of the throat. It is possible to try to extract the object without seeing it, always carefully: taking it with the fingers, or using a toothpick (maybe, because almost any other tool would be too wide for a baby), but the current protocols do not recommend extracting the object if it is not visible (a blind extraction), because of the risk to sink it deeper by accident, and because the compressions could move the object outside by themselves (in some cases). A rescuer that already knows that the choking object is a bag (or similar) does not need to see the object before trying to extract it (because there is no risk of sinking it much deeper, and it is easy to detect by using the touch carefully). Anyway, if any removal is tried and takes too much time, it may require alternating it with the chest compressions at some moments, without hindering to the extraction. And, being the object extracted or not in this step, this CPR procedure must pass to the next action and continue until the babies can breathe by themselves or emergency medical services arrive.

In the next step of the CPR, the rescuer makes ''a rescue breath'', covering the baby's mouth and nose simultaneously with the own mouth, and puffing air inside a first time. After that first rescue breath, it is recommended ''tilting the baby's head'' up and down, trying to open a space for the air in that manner, but leaving it approximately straight again, and then giving ''an additional rescue breath'', for the second time''.'' The rescue breaths usually fail while the object is still blocking, but then the rescuer has only to continue with the next step. Anyway, they can enter and reach the lungs, and then the chest of the baby would be seen rising. If a rescue breath arrived there, it is because the object has been moved to an unknown position that leaves some open space, so it can be useful making the next rescue breaths more softly to avoid moving the object to a new blocking position again, and, in case of those soft rescue breaths are not successful, increasing the strength of blowing in the next ones. The bodies of the babies are delicate, and, when the airway is not clogged, only a little strength in blowing is enough to fill their lungs. The baby's colour would improve after some successful rescue breaths. After the rescue breaths, the rescuer has to return to the 30 initial compressions, repeating the same resuscitation cycle again, continually, until the choking baby regains consciousness and breathe normally, or until the object is extracted but a defibrillation is needed to solve a cardiac arrest (read below).

''Defibrillation'' can also be needed, because a choking infant that is already unconscious can suffer a cardiac arrest at any moment, due to several possible causes.<ref name=":13" /> So it is convenient to ask around for a defibrillator (AED device), for trying a defibrillation on a baby that remains in cardiac arrest after having extracted the stuck object (only if the object has been extracted). Those defibrillators are easy to use, as they emit their instructions with voice messages. One of the pads of the defribrillator (any of them) is attached to the baby's chest, and the other pad to the baby's back.