Circulation - First you want to verify if the child has a pulse.  This can be done by checking the child's carotid artery.  To locate, use the hand holding up the chin and find a voice box (Adam's apple).  Once found, slide your fingers to the side and find if there is a pulse.  If none found, you must proceed to External Chest Compressions. 

External chest compressions provide artificial circulation. When you apply rhythmic pressure on the lower half of the child's breastbone, you force the heart to pump blood. To do external chest compression properly, follow the steps below:

1.  Kneel beside the child's chest.  With the middle and index fingers of your hand nearest the person's legs, find the notch where the bottom rims of the two halves of the rib cages meet in the middle of the chest.                

2.  Now put the heel of one hand on the sternum (breastbone) next to the fingers that found the notch.

3.  Put your other hand on top of the hand that's in position. Be sure to keep your fingers up off the chest wall. It may be easier to do this if you interlock your fingers.

4. When the victim is a child, you may use one hand for compression, instead of two (Difference 3).  The compressions must be 1/3 to 1/2 of the depth of the chest (Difference 4), instead of at least 2 inches in case of an adult. Bring your shoulders directly over the child's sternum and press down, keeping your arm(s) straight.

5.  Then completely relax the pressure on the sternum. Don't remove your hands from the victim's sternum, but do let the chest rise to its normal position between compressions. Relaxation and compression should take equal amounts of time. If you must give both rescue breathing and external chest compressions, the proper rate is 30 chest compressions to 2 breaths. You must compress at a rate of 100 times per minute. Keep interruptions to less than few seconds. Continue administration until help arrives.      

Important:  As of October of 2010, AHA has revised its guidelines for performing effective CPR. If the person is not confident in his/her abilities of performing CPR, for child, first, perform 5 external chest compressions without mouth-to-mouth breathing and then you may call 911. Continue performing compressions until emergency services arrive with Automated External Defibrillator (AED). Based on the recent studies, external compressions can be as effective as combinations of compressions and mouth-to-mouth. If you are trained and/or comfortable performing mouth-to-mouth breathing then administer after the compressions.