Child BLS

Basic Life Support for Children
By,
Urja Meena
Group 5B
Pediatric Basic Life Support;
When a patient experiences a respiratory arrest,

cardiac arrest or obstructed airway, you need to act
swiftly and promptly starting with basic life support
skills.
Pediatric Basic Life Support
Basic Life Support, in general, involves a systematic approach to:
-Initial patient assessment

-Activation of emergency medical services
-Initiation of cardiopulmonary resuscitation (CPR), including defibrillation
International CPR Guidelines
by American Heart Association (AHA)
and International Liaison Committee on Resuscitation (ILCOR) in 2015
Key Actions in Pediatric BLS
1. Verify scene safety

2. Determine unresponsiveness,
get help, and call for
emergency on 112
3. Assess breathing and brachial
pulse
4. Initiate cardiopulmonary
resuscitation (CPR)
1. Verify Scene Safety

- Ensure that the scene is safe for the rescuers and the victim
- e.g. removing the victim from a burning building or safely retrieving a drowning victim
2. Determine unresponsiveness, get help, and call emergency

[112]
-Ifvictim is unresponsive, single rescuer should shout for nearby help and
activate emergency medical response system
-For two or more rescuers, one rescuer continues care for the victim and a
second rescuer calls the emergency number.
3. Assess breathing and pulse

- Rescuer should determine if the
victim is breathing or only gasping
while simultaneously checking for a
pulse within 10 seconds
3.1
No breathing or only gasping and no definite pulse after 10
seconds (SINGLE RESCUER)
-IFTHIS IS NOT A WITNESSED SUDDEN COLLAPSE THEN THE

RESCUER SHOULD START CARDIOPULMONARY RESUSCITATION
(COMPRESSIONS-AIRWAY-BREATHING, C-A-B) WITH A RATIO OF 30
COMPRESSIONS TO 2 BREATHS.
3.1 No breathing or only gasping and no definite pulse after 10

seconds (TWO OR MORE RESCUERS)
-RESCUERS SHOULD START CPR (COMPRESSIONS-AIRWAY-

BREATHING,
C-A-B), STARTING WITH A RATIO 15
COMPRESSIONS TO 2 BREATHS.
3.2
No normal breathing but pulse is present (same actions for single or multiple
rescuers)
-START RESCUE BREATHING BY PROVIDING 1 BREATH EVERY 3 TO 5 SECONDS (12 TO

20 BREATHS/MIN).
-ADD COMPRESSIONS IF PULSE REMAINS ≤60/MIN WITH POOR PERFUSION.
-CONTINUE RESCUE BREATHING. CHECK PULSE EVERY 2 MINUTES. IF NO PULSE,

START CPR (COMPRESSIONS-AIRWAY-BREATHING, C-A-B)
3.3
Normal breathing and pulse are present (same actions for
single or multiple rescuers)
- MONITOR THE VICTIM UNTIL EMERGENCY RESPONDERS

ARRIVE.
4. Initiate cardiopulmonary resuscitation (CPR)
- THE ACTIONS THAT CONSTITUTE CPR ARE PERFORMING CHEST

COMPRESSIONS, OPENING THE AIRWAY, AND PROVIDING
VENTILATIONS (RESCUE BREATHS) OR C-A-B.
Compression Airway Opening Rescue Breaths

CPR sequence of actions for infants and children
1. INITIATE CPR IN AN INFANT OR CHILD WHO IS UNRESPONSIVE, HAS NO NORMAL

BREATHING, AND NO DEFINITE PULSE AFTER 10 SECONDS.
2. START COMPRESSIONS BEFORE PERFORMING AIRWAY OR BREATHING MANEUVERS

(C-A-B).
3. AFTER 30 COMPRESSIONS (15 COMPRESSIONS IF TWO RESCUERS), OPEN THE

AIRWAY AND GIVE 2 RESCUE BREATHS.
4. IF THE PULSE IS ≥60 BEATS PER MINUTE (BPM) AFTER ABOUT 2 MINUTES OF CPR,
CONTINUE VENTILATION.
5. CALL FOR EMERGENCY AND PROCEED BASED ON ANALYSIS.

Chest Compressions
-THE2015 INTERNATIONAL RESUSCITATION GUIDELINES CONTINUE TO

EMPHASIZE THE IMPORTANCE OF PROPER TECHNIQUE WHEN PERFORMING CHEST
COMPRESSION, WITH FULL CHEST RECOIL AND MINIMAL INTERRUPTIONS.
-CHESTCOMPRESSIONS SHOULD BE PERFORMED OVER THE LOWER HALF OF

THE STERNUM.
-COMPRESSION OF THE XIPHOID PROCESS CAN CAUSE TRAUMA TO THE LIVER,

SPLEEN, OR STOMACH, AND MUST BE AVOIDED.
THE EFFECTIVENESS OF COMPRESSIONS CAN BE MAXIMIZED BY ATTENTION TO THE
FOLLOWING:
●THE CHEST SHOULD BE DEPRESSED AT LEAST ONE-THIRD OF ITS ANTERIOR-

POSTERIOR DIAMETER WITH EACH COMPRESSION:
-APPROXIMATELY 4 CM [1.5 INCHES] IN MOST INFANTS
-5 CM [2 INCHES] IN MOST CHILDREN
-COMPRESSIONS IN ADOLESCENTS SHOULD ATTAIN THE RECOMMENDED ADULT DEPTH
OF 5 TO 6 CM, BUT SHOULD NOT EXCEED 6 CM (2.4 INCHES).
●THE OPTIMUM RATE OF COMPRESSIONS IS APPROXIMATELY 100 TO 120 PER

MINUTE. EACH COMPRESSION AND DECOMPRESSION PHASE SHOULD BE OF EQUAL
DURATION.
CHEST COMPRESSIONS FOR INFANTS (YOUNGER THAN

ONE YEAR)
- MAY BE PERFORMED WITH EITHER TWO FINGERS (FOR

SINGLE RESCUER) OR WITH THE TWO THUMB-ENCIRCLING
HANDS (FOR MULTIPLE RESCUERS)
Two fingers technique for

infants’ chest compression
- Compressions are performed with

index and middle fingers, placed on
the sternum just below the nipples.
Two thumb-encircling hands

technique for infants’ chest compression
- The thorax is encircled with both hands and

cardiac compressions are performed with
thumbs which compress over the lower half of
the sternum, avoiding the xiphoid process,
while the fingers are spread around the thorax.
Two-handed chest
compressions for children
(from one year until the onset of
puberty)
- Compressions should be performed

over the lower half of the sternum
with either the heel of one hand or
with two hands.
Ventilation
- CAN BE PROVIDED WITH
MOUTH-TO-MOUTH,
MOUTH-TO-NOSE, OR
WITH A BAG AND MASK.
Ventilation must be provided as follow:
-EACH RESCUE BREATH SHOULD BE DELIVERED OVER 1

SECOND.
-THE VOLUME OF EACH BREATH SHOULD BE SUFFICIENT TO SEE THE CHEST WALL RISE.
-A CHILD WITH A PULSE ≥60 BPM WHO IS NOT BREATHING SHOULD RECEIVE 1 BREATH EVERY 3
TO 5 SECONDS (12 TO 20 BREATHS PER MINUTE).
-INFANTS AND CHILDREN WHO REQUIRE CHEST COMPRESSIONS SHOULD RECEIVE 2 BREATHS
PER 30 CHEST
COMPRESSIONS FOR A LONE RESCUER AND 2 BREATHS PER 15 CHEST COMPRESSIONS FOR TWO
OR MORE RESCUERS.
Automated External
Defibrillator (AED)
– a portable device that is used
extensively to provide prompt
defibrillation to victims in cardiac
arrest.
Actions based on Analysis:
SHOCKABLE RHYTHM – GIVE 1 SHOCK AND RESUME CPR IMMEDIATELY FOR

ABOUT 2 MINUTES OR UNTIL PROMPTED BY THE AED. CONTINUE UNTIL
ADVANCED LIFE SUPPORT PROVIDERS TAKE OVER OR THE VICTIM STARTS TO
MOVE.
NO SHOCKABLE RHYTHM – RESUME CPR IMMEDIATELY FOR ABOUT 2 MINUTES

OR UNTIL PROMPTED BY THE RESCUE. CONTINUE UNTIL ADVANCED LIFE
SUPPORT PROVIDERS TAKE OVER OR THE VICTIM STARTS TO MOVE.
THANK YOU!

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Basic Life Support for Children

When a patient experiences a respiratory arrest,

Basic Life Support, in general, involves a systematic approach to:

-Initial patient assessment

Key Actions in Pediatric BLS

1. Verify scene safety

1. Verify Scene Safety

2. Determine unresponsiveness, get help, and call emergency

3. Assess breathing and pulse

-IFTHIS IS NOT A WITNESSED SUDDEN COLLAPSE THEN THE

3.1 No breathing or only gasping and no definite pulse after 10

-RESCUERS SHOULD START CPR (COMPRESSIONS-AIRWAY-

-START RESCUE BREATHING BY PROVIDING 1 BREATH EVERY 3 TO 5 SECONDS (12 TO

-ADD COMPRESSIONS IF PULSE REMAINS ≤60/MIN WITH POOR PERFUSION.

-CONTINUE RESCUE BREATHING. CHECK PULSE EVERY 2 MINUTES. IF NO PULSE,

- MONITOR THE VICTIM UNTIL EMERGENCY RESPONDERS

4. Initiate cardiopulmonary resuscitation (CPR)

- THE ACTIONS THAT CONSTITUTE CPR ARE PERFORMING CHEST

Compression Airway Opening Rescue Breaths

1. INITIATE CPR IN AN INFANT OR CHILD WHO IS UNRESPONSIVE, HAS NO NORMAL

2. START COMPRESSIONS BEFORE PERFORMING AIRWAY OR BREATHING MANEUVERS

3. AFTER 30 COMPRESSIONS (15 COMPRESSIONS IF TWO RESCUERS), OPEN THE

5. CALL FOR EMERGENCY AND PROCEED BASED ON ANALYSIS.

-THE2015 INTERNATIONAL RESUSCITATION GUIDELINES CONTINUE TO

-CHESTCOMPRESSIONS SHOULD BE PERFORMED OVER THE LOWER HALF OF

-COMPRESSION OF THE XIPHOID PROCESS CAN CAUSE TRAUMA TO THE LIVER,

●THE CHEST SHOULD BE DEPRESSED AT LEAST ONE-THIRD OF ITS ANTERIOR-

●THE OPTIMUM RATE OF COMPRESSIONS IS APPROXIMATELY 100 TO 120 PER

CHEST COMPRESSIONS FOR INFANTS (YOUNGER THAN

- MAY BE PERFORMED WITH EITHER TWO FINGERS (FOR

Two fingers technique for

- Compressions are performed with

Two thumb-encircling hands

- The thorax is encircled with both hands and

- Compressions should be performed

-EACH RESCUE BREATH SHOULD BE DELIVERED OVER 1

Actions based on Analysis:

SHOCKABLE RHYTHM – GIVE 1 SHOCK AND RESUME CPR IMMEDIATELY FOR

NO SHOCKABLE RHYTHM – RESUME CPR IMMEDIATELY FOR ABOUT 2 MINUTES

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