BLS for Infants and Children

47

Infant and Child 1-Rescuer BLS Sequence 

Introduction

If the rescuer is alone and encounters an unresponsive infant or child, follow the steps 
outlined in the BLS Healthcare Provider Pediatric Cardiac Arrest Algorithm for the Single 
Rescuer (Figure 28).

Verify Scene 

Safety, Check for 

Responsiveness, 

and Get Help 

(Algorithm Boxes  

1, 2, 4)

The first rescuer who arrives at the side of an unresponsive infant or child should quickly 
perform the following steps:

Step

Action

1

Verify that the scene is safe for you and the victim. You do not want to become 
a victim yourself.

2

Check for responsiveness. Tap the child’s shoulder or the heel of the infant’s 
foot and shout, “Are you OK?”

3

If the victim is not responsive, shout for nearby help. Activate the emergency 
response system via mobile device (if possible).

Assess for 

Breathing and Pulse 

(Box 3)

Next, assess the infant or child for normal breathing and a pulse. This will help you 
determine the next appropriate actions.

To minimize delay in starting CPR, you may assess breathing at the same time as you 
check the pulse. This should take no more than 10 seconds.

Breathing

To check for breathing, scan the victim’s chest for rise and fall for no more than 10 
seconds.

• 

If the victim is breathing, monitor the victim until additional help arrives.

• 

If the victim is not breathing or is only gasping, the victim has respiratory or (if no 

pulse is felt) cardiac arrest. (Gasping is not considered normal breathing and is a 

sign of cardiac arrest. See Caution: Agonal Gasps in Part 2.)

Check Pulse

• 

Infant: To perform a pulse check in an infant, palpate a brachial pulse (Figure 29A).

• 

Child: To perform a pulse check in a child, palpate a carotid or femoral pulse 

(Figures 29B and C).

It can be difficult for BLS providers to determine the presence or absence of a pulse in 
any victim, particularly in an infant or child. So if you do not definitely feel a pulse within 
10 seconds, start CPR, beginning with chest compressions.

A

B

C

Figure 29.

 

Pulse check. To perform a pulse check in an infant, palpate a brachial pulse (

A

). To perform a pulse check in a child, palpate a 

carotid (

B

) or femoral (

C

) pulse.