PALS Algorithms

Pediatric BLS One Rescuer Algorithm

This algorithm is specifically designed for the management of pediatric emergencies by a single rescuer. It provides a step-by-step guide on how to effectively handle situations where a child is unresponsive, focusing on rapid assessment, initiation of CPR, and use of an Automated External Defibrillator (AED) if appropriate.

Initial Response and Assessment

Ensure Scene Safety: Before approaching, ensure that the environment is safe for both the rescuer and the child.

Check Responsiveness: Attempt to wake the child by tapping and shouting.

Shout for Nearby Help: Quickly seek assistance from nearby individuals without leaving the child.

Activate the Emergency Response System (ERS): If the child remains unresponsive, instruct a bystander to call ERS or do it yourself if alone, then return to the child immediately.

Assess Breathing and Pulse

Check Pulse and Breathing: Assess the child’s pulse and breathing simultaneously for no more than 10 seconds to determine if CPR is needed.

If Pulse Is Irregular or Absent and No Breathing: Prepare to start CPR immediately.

CPR Administration

Begin CPR: Start with compressions at a ratio of 30 compressions to 2 rescue breaths. Ensure compressions are at least one-third the depth of the child’s chest, about 2 inches (5 cm) deep.

Continue CPR: Maintain the 30:2 ratio, switching to a 15:2 ratio if a second rescuer arrives.

Use of AED

Retrieve and Apply AED as Soon as Possible: If an AED is available, apply it as soon as possible after starting CPR. Follow the AED prompts carefully.

Rhythm Check and Shock Delivery: Allow the AED to analyze the rhythm. If a shockable rhythm is detected, administer a shock and then immediately resume CPR.

Continue CPR After Shock: Continue CPR for 2 minutes, then allow the AED to reanalyze the rhythm. Repeat the process if necessary.

Ongoing Management

Activate ERS if Not Already Done: If you were unable to activate ERS before starting CPR, do so at the first possible moment without interrupting CPR.

Continue CPR Until Advanced Help Arrives: Persist with the CPR efforts until professional medical help arrives or the child shows signs of recovery.

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