BLS

We have three groups:

1) Infants – up to 1 year.
2) Children – from 1 year up to puberty.
3) Adults - include adolescents (ie, after the onset of puberty). Signs include chest or underarm hair
in males and any breast development in females.

 Checks responsiveness
 Yells for help, activates the emergency response system, and sends for an AED.
 Checks breathing and pulse simultaneously 5-10 seconds

Compress rate is 100 to 120/min with a depth of compression is more than 5 cm and less than 6 cm, at
least one third of the anterior- posterior diameter of the chest in children and infants - approximately 5 cm
for children and 4 sm for infants.

For infants, single rescuers (whether lay rescuers or healthcare providers) should compress the sternum
with 2 fingers placed just below the nipple line (mammary line).
Although in adults cardiac arrest is often sudden and results from a cardiac cause, in children cardiac
arrest is often secondary to respiratory failure and shock.

The routine use of cricoids pressure in cardiac arrest is not recommended. Although it can prevent gastric
inflation and reduce the risk of regurgitation and aspiration during bag-mask ventilation, it may also block
ventilation and can delay or prevent the placement of an advanced airway and that some aspiration can
still occur despite the use of cricoids pressure.

Feeling a pulse: brachial in an infant and carotid or femoral in a child and carotid in an adult.

For an infant or a child use adult AED pads if the AED does not have child pads.
For infants, a manual defibrillator is preferred to an AED for defibrillation. If it is not available, an AED
equipped with a pediatric dose attenuator is preferred. If neither is available, use an AED for
defibrillation. It is important to remember that you may need to place 1 pad on the chest and 1 on the
back, according to the diagrams on the pads.

The bag-mask ventilation technique is not recommended by a lone rescue during CPR. Position yourself
directly above the victim’s head.

To minimize interruptions during CPR, perform the switch of duties when the AED is analyzing the
rhythm.

Child and infant CPR:

a 15:2 ratio for 2-rescuer CPR

When an advanced airway is in place during 2-rescue CPR, do not stop compressions to give breaths.
Give 1 breath every 6 seconds for adults and 1 breath every 2 to 3 seconds (20 to 30 breaths/ min) in
infants and children. Data show that higher ventilation rates (at least 30 breaths/min in infants less than
1 year of age and at least 25 breaths/min in older children) are associated with improved rates of ROSC
and survival in pediatric in-hospital cardiac arrest.

When victim has a pulse, rescuer should give breaths without chest compressions.
Give 1 breath every 6 seconds (10 breaths per minute) for adults and 1 breath every 2 to 3
seconds (20 to 30 breaths/min) for infants and children.
If the victim is pregnant or obese, perform chest thrusts instead of abdominal thrusts.
Choking in an infant:
5 back slaps + 5 chest compressions
Cardiac Arrest in Pregnancy
Do not delay providing chest compressions for a pregnant woman in cardiac arrest. High-quality CPR can
increase the mother’s and the infant’s chance of survival. If you do not perform CPR on a pregnant
woman when needed, the lives of both the mother and the infant are at risk.
Perform high-quality chest compressions for a pregnant woman in cardiac arrest as you would for any
victim of cardiac arrest. Use an AED for a pregnant woman in cardiac arrest as you would for any victim
of cardiac arrest. If the woman begins to move, speak, blink, or otherwise react, stop CPR and roll her
onto her left side.