Pediatric BLS One Rescuer Algorithm

This algorithm provides guidelines for a single rescuer responding to a pediatric emergency where the child appears unresponsive, outlining critical steps to perform CPR and use an Automated External Defibrillator (AED).

Initial Assessment and Safety

Ensure Scene Safety: First, confirm that the environment is safe for both the rescuer and the child.

Assess Responsiveness: Check if the child is responsive by shouting and gently tapping. If unresponsive, shout for nearby help.

Activate Emergency Response System (ERS): Call emergency services immediately if this has not already been done.

Check Pulse and Breathing

Assess Pulse and Breathing: Quickly assess the child's pulse and breathing status for no more than 5-10 seconds to determine the appropriate next steps.

If there is a pulse but irregular breathing: Perform rescue breathing at a rate of 1 breath every 3-5 seconds (12-20 breaths per minute), monitoring the child’s pulse continuously.

If no pulse and no breathing: Begin CPR immediately.

CPR and AED Deployment

Initiate CPR:

Compression-to-Breath Ratio: Start with a 30:2 compression-to-breath ratio, focusing on delivering high-quality compressions at least one third the depth of the child’s chest.

Use AED As Soon As Available: Apply the AED as soon as it is retrieved. Follow the AED’s prompts to check the rhythm and administer a shock if advised.

If Rhythm Is Shockable: Deliver one shock, then immediately continue CPR for 2 minutes before allowing the AED to recheck the rhythm.

If Rhythm Is Not Shockable: Continue CPR for 2-minute intervals, checking rhythm after each cycle as prompted by the AED.

Continuous Monitoring and Activation of ERS

Activate ERS if Alone: If not done earlier and you are alone, ensure to activate the ERS after starting CPR. Retrieve an AED if not yet done.

Ongoing Assessment: Continue to assess the child’s pulse and deliver rescue breaths every 2 minutes if pulse is below 60 beats/min with signs of poor perfusion.

Persistent Efforts: Maintain CPR and use of the AED, alternating between administering shocks as directed and performing CPR, until ALS providers arrive or the child shows signs of improvement.