2-RESCUER PEDIATRIC BLS

1. verify that the scene is safe for rescuer and victim
2. Check for responsiveness. Tap the child’s shoulder or the bottom of the infant’s foot and shout “are you ok?”
3. if the victim is not responsive, first rescuer begins resuscitation while the second rescuer activates ERS

Scan the victim’s chest for rise and fall for no more than 10 seconds. It may be difficult to detect pulse in a small-bodied victim so if pulse is not detected for 10 seconds, start CPR.

Check for pulse in child victim by palpating a carotid pulse:

1. locate the trachea using 2 or 3 fingers
2. slide fingers into the groove between the trachea and the muscles at the side of the neck, where you can feel the carotid pulse
3. feel the pulse for no less than 5 but no more than 10 seconds. If you do not definitely feel a pulse begin CPR

Check for pulse in infant victim by palpating a brachial artery pulse:

1. place 2 fingers on the inside of the upper arm, midway between the elbow and shoulder
2. press the fingers to attempt to feel the pulse for at least 5 but no more than 10 seconds

If the victim is not breathing normally but a pulse is present, provide rescue breathing:

“Rescue breathing” is giving assisted breaths to an unresponsive victim who has a pulse but is not breathing. This can be done safely with a barrier device or bag-mask, or mouth to mouth if none available. Rescue breaths for infants and children are given at a rate of 1 breath every 3-5 seconds, or about 12 to 20 breaths per minute)

• give each breath in 1 second
• each breath should result in visible chest rise
• check the pulse about every 2 minutes

If the victim is not breathing and no pulse is detected, begin CPR

Child chest compressions

1. the child must be face up on a firm, flat surface. If you must move or roll them over, be extremely careful if you suspect head or neck injury
2. stand or kneel at the victim’s side
3. position your hands and body to perform chest compressions:
   • place the heel of one hand in the center of the victim’s chest, on the lower half of the breastbone (sternum)
   • place the heel of your other hand on top of the first hand
   • straighten your arms and position your shoulders directly over your hands
4. begin chest compressions at a rate of 100 to 120/minute (to the tune of Staying Alive)
5. Press fast and hard, at least 1/3 of chest diameter (about 2 inches or 5 cm), making sure you push straight down on the victim’s breastbone
6. at the end of each compression, allow the chest to recoil completely

As soon as the second rescuer returns, continue to perform 2 rescuer CPR (at compressions-to-ventilation ratio of 15:2), switching positions every 2 minutes or 5 cycles to reduce fatigue.

Infant 2-rescuer chest compressions

1. the infant must be face up on a firm, flat surface. If you must move or roll them over, be extremely careful if you suspect head or neck injury
2. Place both hands side by side in the center of the infant’s chest on the lower half of the breastbone (your thumbs may overlap in very small infants.) Encircle the infant’s chest and support his back with the fingers of both hands.
3. With your hands encircling the chest, use both thumbs to depress the breastbone at a rate of 100 to 120 minute
4. Compress at least 1/3 of the infant’s chest diameter (1 ½ inch or 4 cm)
5. After each compression completely release the pressure on the breastbone, allowing the chest to recoil completely
6. After every 15 compressions pause for no more than 10 seconds to allow the second rescuer to open the airway with a head tilt-chin lift and give 2 breaths, each over 1 second.
7. Continue compressions and breaths at ratio of 15:2. Switch position after about 5 cycles of 2 minutes to avoid fatigue.