BLS for Infants and Children

55

Begin High-Quality 

CPR, Starting With 

Chest Compressions 

(Box 4)

If the victim is not breathing normally or is only gasping and has no pulse, immediately 
do the following:

• 

The first rescuer begins high-quality CPR, starting with chest compressions (see 

Infant/Child Chest Compressions earlier in Part 5 for complete details). Remove or 

move the clothing covering the victim’s chest so that you can locate appropriate 

hand or finger placement for compression. This will also allow placement of the AED 

pads when the AED arrives.

 

–For an infant, use the 2-finger technique until the second rescuer returns to 

provide 2-rescuer CPR. During 2-rescuer CPR, use the 2 thumb–encircling hands 

technique. 

 

–For a child, use 1 or 2 hands (1 hand for a very small child). 

• 

When the second rescuer returns, that rescuer gives breaths.

• 

Rescuers should switch compressors about every 5 cycles or 2 minutes (or earlier 

if needed), so that CPR quality is not reduced because of fatigue (see Critical 

Concepts: High-Performance Teams in Part 2).

Attempt Defibrillation 

With the AED 

(Boxes 5, 6, 7)

Use the AED as soon as it is available and follow the prompts.

Resume 

High-Quality CPR 

(Boxes 6, 7)

After shock delivery or if no shock is advised, immediately resume high-quality CPR, 
starting with chest compressions, when advised by the AED. Continue to provide CPR 
and follow the AED prompts until advanced life support providers take over or the victim 
starts to move.

Review

1.

 What is the correct compression-to-ventilation ratio for a single rescuer of a 3-year-old 

child?

a.  15 compressions to 1 breath

b.  15 compressions to 2 breaths

c.  20 compressions to 2 breaths

d.  30 compressions to 2 breaths

2.

 What is the correct compression-to-ventilation ratio for a 7-year-old child when 2 or 

more rescuers are present?

a.  15 compressions to 1 breath

b.  15 compressions to 2 breaths

c.  20 compressions to 2 breaths

d.  30 compressions to 2 breaths

3.

 For what age victim is the 2 thumb–encircling hands technique recommended when 2 

or more rescuers are present?

a.  A child younger than 3 years

b.  A child older than 3 years

c.  An infant older than 1 year

d.  An infant younger than 1 year