BLS HCP Pediatric Cardiac Arrest Algorithm for Two or More Rescuers
Algorithm at a Glance
- Ensure scene safety.
- Identify responsiveness.
- Check for pulse and respirations.
- Perform CPR as needed.
- Use an AED when available.
Related Video – Understanding the Pediatric Cardiac Arrest Algorithm for Two or More Rescuers
Goals for Management
The rescuer will be able to:
- Quickly recognize the need for BLS
- Intervene quickly using rescue breathing (if trained) and high-quality CPR
- Prevent deterioration
Pediatric BLS for Multiple Rescuers Algorithm Explained
This algorithm outlines the steps for assessing and managing children presenting with a need for basic life support when multiple rescuers are present.
Box 1: Ensure Scene Safety
The rescuer looks around the environment to ensure safety before tending to the child. If the scene is not secure, the rescuer moves the child to a safe area. If the area is safe, the rescuer does not attempt to move the child because movement can worsen the injury.
Box 2: Unresponsive Child
The rescuer taps the child’s shoulder, rubs his feet or belly, and shouts, “are you all right?” If the child does not respond, the second rescuer leaves to find help and activates the emergency response system. The first rescuer can use a cell phone and put the dispatcher on speakerphone for communication.
Box 3: Visualize Chest Rise and Check Pulse
The first rescuer looks for breathing while checking for a pulse in less than 10 seconds.
- If a pulse is present with normal breathing, the rescuer proceeds to Box 3a.
- If a pulse is present with abnormal or absent breathing, the rescuer proceeds to Box 3b.
- If no pulse is present with abnormal or absent breathing, the rescuer proceeds to Box 4.
Box 3a: Pulse Present and Normal Breathing
If the child is breathing and has a pulse, the rescuer should stay with the child until EMS arrives.
Box 3b: Pulse Present and Abnormal Breathing
If the child is not breathing but has a pulse > 60 bpm, the rescuer begins rescue breathing, providing one breath every 2–3 seconds. The rescuer also checks the child’s pulse every 2 minutes. If the child has no pulse and no breathing at any time, the rescuer proceeds to box 4.
Related Video – Understanding Agonal Breathing
Box 4: Initiate CPR
The first rescuer begins CPR with 30 compressions followed by two rescue breaths until the AED arrives. When a second rescuer is available, the rescuers change the compression-to-ventilation ratio to 15 compressions followed by two rescue breaths.
Box 5: Attach AED
When the AED is available, the second rescuer opens the unit and follows the verbal instructions. The rescuer attaches the pads per the diagram on the AED. Compressions are paused to allow the AED to analyze the heart rhythm.
- If the AED determines the child’s rhythm is shockable, it will tell the rescuers to deliver a shock. The rescuers proceed to Box 6.
- If the AED determines that the child’s rhythm is non-shockable, it will tell the rescuers to continue CPR. The rescuers proceed to Box 7.
Box 6: Administer Shock
The rescuers ensure that no one is touching the child and push the shock button on the AED. The rescuers immediately resume CPR following the shock.
Box 7: Resume CPR
The rescuers immediately resume high-quality CPR until advised by the AED to stop for a rhythm check. The rescuers continue to provide CPR and shocks until the child moves or EMS arrives.
A rescuer performs infant CPR.
A rescuer performs child CPR.
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