4.1 Pediatric Basic Life Support (BLS)

Definition

The American Heart Association (AHA) guidelines define a child as anyone from about 1 year of age to the onset of adolescence, identified by the presence of secondary sex characteristics (puberty). An infant is a child under 1 year of age, except for neonatal victims such as newborns in the first few hours after birth.

Single Rescuer BLS

1. Verify Scene Safety: Ensure the area is safe for both the rescuer and the victim.
2. Check for Responsiveness:
   • For a child: Tap the child’s shoulder and shout, “Are you okay?”
   • For an infant: Tap the bottom of the infant’s foot and shout, “Are you okay?”
3. Call for Help: If the victim is unresponsive, shout for nearby assistance.
4. Activate the Emergency Response System (ERS): Call 911 or mobilize an Advanced Life Support (ALS) team if available.

Assess Breathing and Pulse

• Scan the victim’s chest
  ×

  Scan the victim’s chest

  
  for rise and fall for no more than 10 seconds.
• It may be difficult to detect a pulse in smaller victims, so if a pulse is not detected within 10 seconds, begin CPR immediately.

Checking for a Pulse in a Child

Checking for a Pulse in a Child (same as in adult)

• Locate the trachea using two or three fingers.
• Slide your fingers into the groove between the trachea and the muscles at the side of the neck, where the carotid pulse can be felt.
• Feel for at least 5 seconds but no more than 10 seconds. If no pulse is detected, begin CPR.

Checking for a Pulse in an Infant

• Place two fingers on the inside of the upper arm, midway between the elbow and shoulder.
• Press gently to attempt to feel the pulse for at least 5 seconds but no more than 10 seconds.

Rescue Breathing (If Pulse is Present, But No Normal Breathing)

Rescue breathing provides assisted breaths to an unresponsive victim who has a pulse but is not breathing.

This can be performed using:

• A barrier device (e.g., face shield or mask).
• A bag-mask device, if available.
• Mouth-to-mouth if no other options exist.

Rescue Breathing for Infants and Children:

• Provide 1 breath every 3–5 seconds (about 12 to 20 breaths per minute).
• Each breath should be given over 1 second and should result in visible chest rise.
• Recheck the pulse approximately every 2 minutes.

When to Begin CPR

If the victim is not breathing and has no pulse, begin CPR immediately.

If Pulse Is…	And Breathing Is…	Then…
Absent	Not normal (or absent)	Start full CPR immediately (30:2 for single rescuer, 15:2 for two rescuers).
Present	Not breathing normally	Begin rescue breathing (1 breath every 3–5 sec).
Present	Normal	Monitor the victim and wait for EMS.