We strongly recommend that the primary child-care provider in the family (as well as anyone else who cares for children on a regular basis) complete a good hands-on course in emergency first aid that includes infant and childhood cardiopulmonary resuscitation (CPR) procedures. There is simply no substitute for the instruction and practice you will get in a good first aid course.

The following are general guidelines to follow in responding to any emergency, no matter what its nature.

What to Do in an Emergency

Stay calm. Take a moment to assess what has happened. It won't help your child if you scream or panic. Your child needs you to be a calm and reassuring presence.

Make sure your child is breathing and check for a pulse. For an infant under one year, check for a pulse on the artery by placing the tips of your first two fingers on the infant's inner arm above the elbow. For a child older than one year, check for a pulse on the carotid artery, located at the side of the neck. Touch your first two fingers to the Adam's apple, and run your fingers across the neck to the depression between the Adam's apple and the large neck muscle. Allow five to ten seconds to feel for a pulse. If your child is not breathing or does not have a pulse, read Cardiopulmonary Resuscitation (CPR). Begin performing CPR at once.

Check for bleeding and for obviously broken bones.

Try to determine what has happened. If your child can respond, ask. If not, observe the surroundings. For example, is there a bottle of pills or cleaning compounds nearby? Is the child lying on her back under a tree? If the person is unknown to' you, is she wearing a Medic Alert bracelet that identifies a specific medical condition? The few moments you take to assess the situation are vitally important. After close observation, you'll have a better sense of whom to call and what to do. Without careful assessment, you are more likely to panic and do the wrong thing.

If you suspect a head, neck, or spinal injury, do not pick up or move the child, even to offer comfort. Moving someone with a possible head, neck, or back injury can worsen the damage. Unless there is a threat that the child will vomit and choke, it is best to leave her in the same position in which you found her. Rely on medical personnel to know how to stabilize the child so that transport to the hospital will be safe.

Call for emergency help. When calling for emergency help, speak distinctly. Give your name, the address you're calling from, your phone number, and your assessment of the situation. Don't rush. If you remain calm, you will save time in the long run. If you give clear, distinct, precise information so that the operator can route emergency help to your location quickly, you won't have to repeat your message. Try to relate enough of the problem so that the people who respond to your call will be prepared to deal with it when they arrive. You don't have to know exactly what's wrong; just convey as clearly and completely as you can what you have observed and what your assessment of the situation is.