RQI Basic Life Support (BLS) Provider Practice Test

Opening the airway first is essential because air must have a clear path to reach the lungs. So you place the infant in a neutral or gently extended head position with a head tilt-chin lift to lift the tongue away from the airway. Once the airway is open, you create a tight seal around the infant’s mouth and nose with your mouth (mouth-to-mouth-and-nose) and give one breath, lasting about one second, watching for the chest to rise. This confirms that air is entering the lungs. If the chest does not rise, reposition and retry.

Why this order matters: starting with an open airway ensures the breath isn’t blocked by a displaced tongue or soft tissues, making the ventilation effective. Delivering a breath with the airway open and a proper seal is the key to successful ventilation. The other approaches—sealing before opening the airway, delivering two breaths before rechecking, or using only mouth breathing—don’t provide reliable ventilation for an infant.