Pediatric BLS Algorithm - Two-Rescuer

This algorithm provides a structured approach for two rescuers responding to a pediatric emergency involving an unresponsive victim. It emphasizes teamwork, rapid intervention, and continuous assessment to improve the chances of recovery for the child.

Initial Response and Setup

Ensure Scene Safety: Both rescuers ensure the scene is safe before approaching the victim.

Assess Responsiveness and Activate Help:

Rescuer 1: Stays with the victim, assessing responsiveness by shouting and gently tapping the child.

Rescuer 2: Immediately activates the Emergency Response System (ERS) and retrieves the AED and other emergency equipment.

Assessment and Monitoring

Check Pulse and Breathing: Rescuer 1 checks the child’s pulse while assessing for breathing or gasping, doing so for no more than 5-10 seconds.

CPR and AED Usage

Begin CPR:

• Rescuer 1: Starts CPR with a 30:2 compression-to-breath ratio.
• Switch to 15:2 Ratio: When Rescuer 2 returns, they adjust to a 15:2 ratio to optimize the CPR effort with less fatigue and more efficiency.

Apply AED As Soon As Possible: As soon as Rescuer 2 returns with the AED, apply it to the child and follow its prompts.

Rhythm Check and Shock Delivery:

If Rhythm is Shockable: Administer one shock, then immediately resume CPR for 2 minutes before rechecking.

If Rhythm is Not Shockable: Continue CPR for 2 minutes, then pause briefly for the AED to recheck the rhythm.

Ongoing Management

Rescue Breathing: If the child has a pulse but is breathing poorly, perform rescue breathing at a rate of one breath every 3-5 seconds.

Continuous Assessment: Every 2 minutes, reassess the pulse and breathing, adjusting the response as needed based on the child’s condition and AED prompts.

Continue Until ALS Arrives: Both rescuers continue CPR and other supportive measures until advanced life support (ALS) providers arrive or the child shows signs of recovery.