Pediatric Basic Life Support
Pediatric BLS differs from adult BLS in its emphasis on prevention, its compression-to-ventilation ratio, and its depth targets. For a child or infant who is unresponsive and not breathing normally, the rescuer should first provide about 2 minutes of CPR before leaving to activate the emergency response system if alone-unless a mobile phone is immediately available, in which case call while starting CPR. This "CPR first" approach reflects that pediatric arrest is often hypoxic/asphyxial, so ventilation matters greatly.
Ratios and technique
- Single rescuer: 30:2 for both children and infants.
- Two rescuers: 15:2 for both children and infants.
- Compression depth: at least one third the anterior-posterior chest diameter-about 2 inches (5 cm) for children and about 1.5 inches (4 cm) for infants.
- Infant compressions: two fingers for a single rescuer, or the two-thumb encircling-hands technique for two rescuers.
- Child compressions: one or two hands, depending on the child's size.
- Airway: head tilt–chin lift; for infants avoid excessive head tilt that can occlude the airway.
Traps to watch
A frequent distractor is applying the adult 30:2 ratio to a two-rescuer pediatric scenario (the correct answer is 15:2). Another trap is choosing adult compression depth for an infant. A third is forgetting the "2 minutes of CPR before leaving to call" rule for a lone rescuer. Also remember that for a child who has a pulse but is not breathing adequately, give rescue breaths at about 1 breath every 2–3 seconds (20–30/min) and reassess.
Rule of thumb: Pediatric arrest is usually a breathing problem-ventilate well, and when alone, do CPR for 2 minutes before going for help.