Pediatric basic life support

PBLS Intro - Scene, Safety, Stimulate

• 1. Scene Safety: First, ensure the environment is safe for you and the child. Check for hazards like traffic, fire, or electrical wires before approaching.

• 2. Check for Response (Stimulate):

  • Child: Tap shoulders firmly and shout, "Are you alright?"
  • Infant: Tap the soles of the feet.

• 3. Shout for Help: If unresponsive, shout for help. Activate the emergency response system / call for a code blue.

⭐ For an infant, the correct technique to check for responsiveness is to tap the soles of the feet. Shaking can cause injury.

The BLS Algorithm - Rescue Rhythm

• After initial assessment, simultaneously check for breathing and a central pulse (brachial/femoral) for no more than 10 seconds.

• Rescue Breathing (Pulse present, breathing absent/inadequate):
  • Give 1 breath every 2-3 seconds (20-30 breaths/min).
  • Ensure visible chest rise with each breath.
  • Re-check pulse every 2 minutes. If it drops below 60/min with poor perfusion, start full CPR.

⭐ The most common cause of bradycardia and cardiac arrest in children is progressive hypoxia and respiratory failure, not a primary cardiac event.

• CPR (No pulse or pulse < 60/min with poor perfusion):
  • Immediately begin cycles of chest compressions and ventilations.
  • Ratio: 30:2 for a single rescuer, 15:2 for two rescuers.

CPR Technique - The Right Moves

• Compressions: Push Hard, Push Fast

  • Rate: 100-120/min.
  • Depth: At least ⅓ of chest AP diameter.
    • Infants: ~4 cm (1.5 inches).
    • Children: ~5 cm (2 inches).
  • Action: Allow complete chest recoil after each compression.

• Hand Position

  • Infants (<1 yr):
    • 1 Rescuer: Two-finger technique below the nipple line.
    • 2 Rescuers: Two thumb-encircling hands technique (preferred).
  • Children (1 yr to puberty):
    • Use one or two hands on the lower half of the sternum.

• Compression:Ventilation (C:V) Ratio
  • Single Rescuer: 30:2
  • Two Rescuers: 15:2

⭐ The two thumb-encircling hands technique for infant CPR is superior as it generates better blood flow and coronary perfusion pressure.

Choking (FBAO) - Unblock the Airway

• Goal: Relieve obstruction & restore airflow. Technique varies by age and consciousness.

⭐ Never perform a blind finger sweep. Only attempt to remove a foreign body if it is clearly visible, to avoid pushing it further into the airway.

High-Yield Points - ⚡ Biggest Takeaways

• Follow the C-A-B sequence (Chest Compressions, Airway, Breathing) for resuscitation.
• The compression-ventilation ratio is 30:2 for a single rescuer and 15:2 for two rescuers.
• Maintain a compression rate of 100-120/min.
• Compress to a depth of at least one-third the AP diameter of the chest.
• Check the brachial artery pulse in infants and the carotid/femoral artery in children.
• Start compressions if the pulse is <60/min with poor perfusion.