Many similarities exist between the BLS guidelines for Adults and Children. The main differences between the two are:
- For children, the compression to breaths ratio is 30:2 for one rescuer and 15:2 for two rescuers for all age groups.
- The depth of compression may be different. For a child, compress the chest at least one-third the depth of the chest. This may be less than two inches for small children but will be approximately two inches for larger children (4-5 cm).
- If you are the only rescuer at the scene and find an unresponsive child, perform CPR for two minutes before you call EMS or before you go look for an AED. The ILCOR emphasizes that cell phones are available everywhere now, and most have a built-in speakerphone, so you can call EMS while being with the child.
- In children, primary cardiac events are not common. Cardiac arrest is most commonly preceded by respiratory problems. Survival rates improve with early intervention for respiratory problems. Remember that prevention is the first link in the Pediatric Chain of Survival.
- If you witness a cardiac arrest in a child, call EMS and get an AED as you would in the Adult BLS sequence.
One-Rescuer BLS for Children
If you are alone with a child at the scene, do the following:
- Tap and talk loudly to the child to determine if they are responsive.
- Assess for breathing while simultaneously checking for the child’s carotid pulse (on the side of the neck) or femoral pulse (on the inner thigh in the crease between their leg and groin) for 5 but no more than 10 seconds.
- If the child does not respond and is not breathing (or only gasping), yell for help. If someone answers, send them to call 911/EMS and to get an AED.
- Feel for the child’s carotid pulse (on the side of the neck) or femoral pulse (on the inner thigh in the crease between their leg and groin) for 5 but no more than 10 seconds.
- If you cannot feel a pulse (or if you are unsure), begin CPR by doing 30 compressions followed by two breaths. If you can feel a pulse but the pulse rate is less than 60 beats per minute, you should begin CPR. This rate is too slow for a child.
- After doing CPR for about two minutes (usually about five cycles of 30 compressions and two breaths), and if other help has not arrived, call EMS while staying with the child. The ILCOR emphasizes that cell phones are available everywhere now and most have a built-in speakerphone. Get an AED if you know where one is.
- Use and follow AED prompts when available while continuing CPR until EMS arrives or until the child’s condition normalizes.
Two-Rescuer BLS for Children
If you are not alone with a child at the scene, do the following:
- Tap and talk loudly at the child to determine if they are responsive.
- Assess for breathing while simultaneously checking for the child’s carotid pulse (on the side of the neck) or femoral pulse (on the inner thigh in the crease between their leg and groin) for 5 but no more than 10 seconds.
- If the child does not respond and is not breathing (or if only gasping), have the second rescuer call 911/EMS and get an AED. (The ILCOR emphasizes that cell phones are available everywhere now and most have a built-in speakerphone, so you or the second rescuer can call 911/EMS without leaving the scene).
- Feel for the child’s carotid pulse (on the side of the neck) or femoral pulse (on the inner thigh in the crease between their leg and groin) for 5 but no more than 10 seconds.
- If you cannot feel a pulse (or if you are unsure), begin CPR by doing 15 compressions followed by two breaths. If you can feel a pulse but the pulse rate is less than 60 beats per minute, you should begin CPR. This rate is too slow for a child.
- When the second rescuer returns, begin doing CPR by performing 15 compressions by one rescuer and two breaths by the second rescuer.
- Use and follow AED prompts when available while continuing CPR until EMS arrives or until the child’s condition normalizes.