3.5 Two-Rescuer Adult BLS

Overview

When two rescuers are present, Basic Life Support becomes more efficient. One rescuer initiates CPR while the other activates the Emergency Response System (ERS), retrieves an AED, and assists with rescue breathing. Roles should be coordinated, clear, and focused on minimizing interruptions in chest compressions.

Two-Rescuer Workflow

• Rescuer 1: Begins high-quality chest compressions immediately (30:2 ratio)
• Rescuer 2: Activates ERS, retrieves AED and airway equipment, then assists with ventilation
• After 30 compressions, Rescuer 2 delivers 2 breaths using a bag-mask or barrier device
• Rescuers switch roles every 2 minutes or sooner if fatigued

Effective Communication

Clear communication is critical to ensure smooth transitions and uninterrupted care. Rescuers should:

• Announce when it is time to switch roles
• Give verbal confirmation during handoffs (e.g., “You take over compressions”)
• Coordinate breath timing so compressions resume immediately after the second breath

Use of AED During Two-Rescuer CPR

• Apply the AED as soon as it arrives
• Rescuer 1 continues compressions while Rescuer 2 powers on and applies AED pads
• Follow AED prompts
• Clear the victim during rhythm analysis and shock delivery
• Resume CPR immediately after the shock (or if no shock is advised)

Compression-to-Ventilation Ratio

In adult victims, the compression-to-ventilation ratio remains 30:2 regardless of the number of rescuers. Only the efficiency of care improves with multiple rescuers.