BLS Algorithm
Basic Life Support step-by-step protocol per AHA 2020 guidelines. Select patient type below.
Scene Safety & Recognition
Ensure the scene is safe before approaching. Tap shoulders firmly and shout "Are you okay?" Look for absent or abnormal (gasping) breathing.
Activate Emergency Response & Get AED
Call emergency services (or send someone). For a witnessed sudden collapse, retrieve AED first before calling if one is nearby.
Check Pulse
Check carotid pulse for no more than 10 seconds. Simultaneously look for signs of breathing.
Chest Compressions
Hand position: Heel of one hand on lower half of sternum (between nipples), other hand on top, fingers interlaced. Arms straight, elbows locked.
Rate: 100–120 per minute (push to beat of "Stayin' Alive").
Depth: At least 2 inches (5 cm) — no more than 2.4 inches (6 cm).
Recoil: Allow full chest recoil between compressions — do not lean on chest.
Airway & Rescue Breaths
After 30 compressions, open airway with head-tilt chin-lift. Pinch nose, seal mouth, give 2 breaths over 1 second each. Watch for chest rise.
Use AED When Available
Power on AED. Attach pads: one below right collarbone, one on left side below armpit. Clear the victim during analysis. Deliver shock if advised.
Continue Until
Do not stop unless: EMS providers take over, victim shows obvious signs of life (normal breathing, purposeful movement), AED advises no shock and victim is breathing normally, or you are physically unable to continue.
Scene Safety & Recognition
Check scene safety. Tap shoulders and call the child's name. Check for responsiveness and breathing.
Activate Emergency Response
If alone: give 2 minutes of CPR first, then call emergency services. Most paediatric arrests are respiratory in origin — early CPR is critical.
Check Pulse
Check carotid or femoral pulse for no more than 10 seconds.
Chest Compressions
Hand position: 1 or 2 hands on lower half of sternum (use one hand for smaller children).
Depth: At least 2 inches (5 cm) or 1/3 anterior-posterior chest diameter.
Rate: 100–120 per minute. Full recoil between each compression.
Airway & Rescue Breaths
Head-tilt chin-lift. Seal mouth over child's mouth, give 2 breaths. Watch for visible chest rise. Avoid excessive ventilation.
Use AED
Paediatric pads/attenuator if available — use for children under 8. If only adult pads available, use them (do not delay defibrillation). Ensure pads do not touch each other.
Responsiveness & Scene Safety
Tap the bottom of the foot (not the shoulders). Shout. Check for responsiveness and absent or abnormal breathing.
Activate Emergency Response
If alone: give 2 minutes of CPR before calling emergency services. Paediatric arrests are almost always respiratory — CPR is the priority.
Check Brachial Pulse
Check the brachial artery (inner upper arm) for no more than 10 seconds.
Chest Compressions
Technique (1 rescuer): 2-finger technique — place 2 fingers on centre of chest, just below the nipple line.
Technique (2 rescuers): 2-thumb encircling technique — preferred; produces better blood pressure.
Depth: ~1.5 inches (4 cm) or 1/3 chest diameter.
Rate: 100–120/min. Allow full recoil.
Airway & Rescue Breaths
Neutral head position (slight tilt — not full extension). Cover both mouth and nose with your mouth. Give 2 gentle puffs — just enough to see chest rise. Avoid overventilation.
AED for Infants
Manual defibrillator preferred if available. If only AED: use paediatric pads/attenuator. If neither available, use adult AED — do not delay.
Source: AHA 2020 CPR & ECC Guidelines. Reviewed Sep 2026. For certification, complete an AHA or equivalent hands-on BLS course.
Training reference only. This page is not a substitute for hands-on BLS certification. Always follow your institution's current protocols. In a real emergency, activate emergency services immediately.