Pediatric Advanced Life Support

Differences in BLS for Infants and BLS for Children INFANTS (0 to 12 months) CHILDREN ( 1 year to puberty) According to the 2020 CPR guidelines, for all ages of children, the new ratio of compressions to ventilations should be 15:2. Check for infant’s pulse using the brachial artery on the inside of the upper arm between the infant’s elbow and shoulder. Check for child’s pulse using the carotid artery on the side of the neck or femoral pulse on the inner thigh in the crease between the leg and groin. Perform compressions on the infant using two fingers (if you are by yourself) or two thumbs with hands encircling the infant’s chest (with two rescuers). Perform compressions on a child using one or two-handed chest compressions depending on the size of the child. Compression depth should be one-third of the chest depth; for most infants, this is about 1.5 inches (4 cm). Compression depth should be one-third of the chest depth; for most children, this is 2 inches (5 cm). If you are the only person at the scene and find an unresponsive infant or child, perform CPR for two minutes before you call EMS or go for an AED. If you witness a cardiac arrest in an infant or child, call EMS and get an AED before starting CPR. Table 2 BASIC LIFE SUPPORT 3 CHAPTER Basic Life Support (BLS) utilizes CPR and cardiac defibrillation when an Automated External Defibrillator (AED) is available. BLS is the life support method used when there is limited access to advanced interventions such as medications and monitoring devices. In general, BLS is performed until the emergency medical services (EMS) arrives to provide a higher level of care. In every setting, high-quality CPR is the foundation of both BLS and PALS interventions. High-quality CPR gives the child or the infant the greatest chance of survival by providing circulation to the heart, brain, and other organs until return of spontaneous circulation (ROSC). This handbook covers PALS and only briefly describes BLS. All PALS providers are assumed to be able to perform BLS appropriately. It is essential that PALS providers be proficient in BLS first. High-quality BLS is the foundation of PALS. 9 PALS – Pediatric Advanced Life Support BLS FOR CHILDREN (1 YEAR TO PUBERTY) BLS for both children and infants is almost identical. For example, if two rescuers are available to perform CPR, the compression to breath ratio is 15:2 for both children and infants. ONE-RESCUER BLS FOR CHILDREN If you are alone with a child, do the following: 1. Tap their shoulder and talk loudly to the child to determine if they are responsive. 2. If the child does not respond and is not breathing (or is only gasping for breath), yell for help. If someone responds, send the second person to call 911 and to get an AED. 3. Assess if they are breathing while feeling 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 no more than 10 seconds. 4. 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. 5. After doing CPR for about two minutes (usually about ten cycles of 15 compressions and two breaths) and if 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.