BLS for Infants (0 – 12 months)

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PALS BLS Infants compressions

Figure 2

BLS for children and infants is nearly the same. For example, if two individuals are ready to perform CPR on-site, the breath to compression ratio is 15:2 for both children and infants. The main differences between BLS for children and infants are: (Table 2 previous lesson):

  • The pulse of the infant is located through the brachial artery, found on the inside of upper arm between the infant’s elbow and shoulder.
  • When executing CPR, compressions can be done with two fingers (with one rescuer) or two-thumb encircling hands (if there are two rescuers and one of their hands is big enough to perform this) (Figure 2).
  • One third of the chest is the recommended compression depth, which is usually about 1.5 inches (4 cm) for most infants.
  • Cardiac arrests are uncommon among infants and are usually a complication brought about by respiratory problems. The infant’s survival rate improves when the respiratory complication is readily solved. Remember that prevention is the first step in the Pediatric Chain of Survival.

One-Rescuer BLS for Infants

As the sole rescuer at the scene of an emergency, make sure to take the following actions:

  1. Engage with the infant by talking loudly or tapping their shoulder to assess the patient’s responsiveness
  2. Study the patient’s breathing pattern
  3. Call for help once you ascertain that the infant is not responsive or is not breathing properly. In the event that someone arrives to help you, ask that person to call 911 for help or to secure an AED. (The AHA points to the universality of speakerphone function in mobile phones, allowing rescuers to stay within the emergency site)
  4. For no more than 10 seconds, locate the infant’s brachial pulse (Figure 3a).
  5. If you fail to feel a pulse, start with 30 compressions and then two breaths. If the pulse rate is less than 60 beats per minute, start with CPR. In performing CPR to an infant, follow these steps: (Figure 3b):
    • a.) Place the infant on a hard surface, face-up.
    • b.) Compress the infant’s chest using two fingers, but make sure not to press the end of the infant’s sternum, as this may lead to serious injuries.
    • c.) Keep your compressions at 100 per minute, with a depth of at least 1.5 inches
  6. For about two minutes, execute CPR operations of about 30 compressions and two breaths for five cycles. If help has yet to arrive, call 911 and secure an AED. (The AHA points to the universality of speakerphone function in mobile phones, allowing rescuers simultaneously attend to the infant while calling for help)
  7. Follow the instruction on the AED while executing CPR until EMS arrives or until the child recuperates into a more stable condition.
BLS Infant CPR - Pulse
BLS Infant CPR - Fingers placement

Figure 3

Two-Rescuer BLS for Infants

If you are with a second rescuer with the infant, do the following:

  1. Engage with the infant by talking loudly or tapping their shoulder to assess the patient’s responsiveness.
  2. Study the patient’s breathing pattern.
  3. Call for help once you ascertain that the infant is not responsive or is not breathing properly. Ask the second person to call 911 for help or to secure an AED. (The AHA points to the universality of speakerphone function in mobile phones, allowing rescuers to stay within the emergency site.)
  4. For no more than 10 seconds, locate the infant’s brachial pulse.
  5. If you fail to feel a pulse, start with 30 compressions and then two breaths. If the pulse rate is less than 60 beats per minute, start with CPR. In performing CPR to an infant, follow these steps:
    • a. Place the infant on a hard surface, face-up.
    • b. Compress the infant’s chest using two fingers but make sure not to press the end of the infant’s sternum as this may lead to serious injuries.
    • c. Keep your compressions at 100 per minute, with the depth of at least 1.5 inches.
  6. Together with the second rescuer, perform 15 compressions with one person and two breaths with the second person. If one of you can fit your hands around the infant’s chest, execute CPR using two thumb-encircling hands method. Refrain from pressing the end of the infant’s sternum as this will inevitably lead to serious injuries.
  7. A rate of 100 compressions per minute is standard when dealing with infants, at about 1.5 inches deep.
  8. Follow the instructions on the AED and continue with CPR until EMS arrives or until the infant recuperates into a more stable condition.
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