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
- Verify Scene Safety: Ensure the area is safe for both the rescuer and the victim.
- 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?”
- Call for Help: If the victim is unresponsive, shout for nearby assistance.
- 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 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
- 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.