One & Two Rescuer BLS for Children

If you find yourself as the only individual in the presence of the patient, proceed with the following steps:

1. Engage with the child by tapping their shoulder or talking to assess responsiveness.
2. Assess for breathing while simultaneously checking 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 5 but no more than 10 seconds.
3. If the child is unresponsive, call for help. If someone comes over to help, do not leave the child; ask the second person to call 911/EMS or to get an AED.
4. For 5 but no more than 10 seconds, attempt to assess the child’s carotid pulse (found on the side of the neck) or femoral pulse (found on the inner thigh in between the leg and the groin).
5. If you do not feel a pulse, start CPR with 30 compressions followed by two breaths. If you feel a weak pulse, which is generally less than 60 beats per minute (too slow even for a child), start with CPR.
6. After executing about five cycles of 30 compressions and two breaths within two minutes, and in the event that help has yet to arrive, phone EMS to report the incident while staying close to the child. Retrieve an AED if possible.
7. Use and follow AED prompts when available while continuing CPR until EMS arrives or until the child’s condition normalizes.

If you are with a second person with a child at the scene, do the following:

1. Engage with the child by tapping their shoulder or talking to assess responsiveness
2. Check for breathing while simultaneously checking 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 5 but no more than 10 seconds.
3. Have the second person call 911/EMS if the child is unresponsive or is having trouble breathing. Have the second person try to secure an AED as well. (The ILCOR points out that phones are universally available with speakerphone features, allowing you to call 911/EMS without having to leave the emergency site.)
4. For 5 but no more than 10 seconds, attempt to assess the child’s carotid pulse (found on the side of the neck) or femoral pulse (found on the inner thigh in between the leg and the groin).
5. If you do not feel a pulse (or if you are not sure), begin CPR by doing 15 compressions followed by two breaths. If you do 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.
6. Proceed with CPR with 15 compressions with one rescuer and two breaths with the second rescuer as soon as you have another person available.
7. Follow the AED instructions while executing CPR until EMS arrives or until the child’s condition improves.