BLS CHILDREN

BLS INFANTS
Dr Firdaus Bin Baharuddin

2020 AHA guidelines for BLS in pediatric

INTRODUCTION
◦ Numerous causes for cardiac arrest in children
◦ Respiratory (i.e. Asthma, Aspiration Pneumonia Smoke Inhalation, Drowning, Choking)
◦ Cardiac (i.e. Congenital lesion, commotion cordis, arrhythmias, cardiomyopathy)
◦ Infectious (i.e. Sepsis, Meningitis, Pneumonia)
◦ Trauma (i.e. Blunt trauma to the head,chest, child abuse, drowning)
◦ Others (Sudden Infant Death SyndromeSIDS)
◦ Respiratory insufficiency > Primary Cardiac Problem
https://www.youtube.com/watch?v=namI2ZjZxKs
https://www.youtube.com/watch?v=yId2qthfp3o
Why BLS very important?
◦ Outcome of unwitnessed cardiopulmonary arrest in infant and children is poor
◦ 8.4 % of out-of-hospital cardiac arrest survive to discharge, mostly
neurologically impaired
◦ Learning CPR is one of the most powerful tools to reduce death rates from
sudden cardiac arrest
◦ The better trained a population is, the more likely that a bystander will step in
and perform lifesaving techniques to keep the victim alive until EMS arrive
2020 AHA guidelines for BLS in
pediatric
◦ Pediatric patients apply to those between the ages of 1 year to puberty.
◦ Chest, underarm hair on males
◦ Breast development in females
◦ Infant guidelines apply to those who are younger than 1 year
Pediatric Chains of Survival
Sequences for Pediatric & Infant BLS
Sequences for Pediatric & Infant BLS
 Verify scene is SAFE
for you and victim
Tap the child’s shoulder and shout
“are you OK?”
Or Infant’s foot
Shout for help, call
999

Check breathing
victim’s chest rise and
fall

Check Pulse
Danger/Scene safety
Check for Response

◦ Shoulder tap ◦ Tap bottom of the foot

◦ Shout “Are you OK?” ◦ Shout “Are you OK?”
 CALL FOR HELP
Shout for Help 999
ACTIVATE
EMERGENCY
RESPONSE
SYSTEM
Check for breathing
https://www.youtube.com/
watch?v=T85vd3CBs04

Check breathing victim’s chest rise and fall

Check Pulse

◦ Locate the trachea

◦ Using 2 finger
◦ Slide the 2 finger into groove between trachea
and the muscles at the side of the neck

◦ Place 2 finger in the inner thigh, midway

◦ Place 2 finger on the inside of the upper from hipbone and pubic bone, just below
arm, midway between shoulder and elbow the crease
◦ Press the finger , attempt to feel the pulse
at least 5 second, but no more than 10
seconds
 Verify scene is SAFE
for you and victim
Tap the child’s shoulder and shout
“are you OK?”
Or Infant’s foot
Shout for help, call
999

Check breathing
victim’s chest rise and
fall

Check Pulse
DR CAB
Infant/Child CPR
◦ Universal rate of compression 100-120/minutes
◦ Compression to rescue breathing/ventilation ratio
◦ 30 : 2 (for 1 rescuer)
◦ 15 : 2 if 2 rescuer
◦ Chest Compression Technique
◦ Children 1 or 2 hand same as for an adult
◦ Very small child 1 handed compression is adequate to
◦ achieve desired compression depth
◦ Infant 2-finger technique
◦ Multiple rescuer 2 thumb-encircling hands technique
Infant (1 Rescuer) : 2-Finger Technique
Step Action
1 Place the infant on a firm, flat surface
2 Place 2 finger in the center of the infant’s chest, just below the nipple line, on the lower
half of the breastbone
3 Give compression at rate of 100 to 120/min
4 Compress at least one third of AP diameter of infant’s chest ~ 4cm
5 To allow chest recoils, do not lean on the chest
6 After 30 compression, open the airway with head tilt chin lift -give 2 breath each over 1
second
7 After 5 cycle or 2 minutes of CPR in ration 30:2
8 Continue compression 30:2, use AED as soon as it is available
Infant : 2 Thumb-Encircling Hand
Technique
Step Action
1 Place the infant on a firm, flat surface
2 Place 2 finger in the center of the infant’s chest, just below the nipple line, on the lower
half of the breastbone
3 Give compression at rate of 100 to 120/min
4 Compress at least one third of AP diameter of infant’s chest ~ 4cm
5 To allow chest recoils, do not lean on the chest
6 After 30 compression, open the airway with head tilt chin lift -give 2 breath each over 1
second
7 After 5 cycle or 2 minutes of CPR in ration 30:2
8 Continue compression 30:2, use AED as soon as it is available
When to stop CPR ?
◦ Victim recovers
◦ Ambulance Team arrives
◦ Another rescuer takes over
◦ Too tired to continue