Basic life support (BLS) is the fundamental approach to saving lives following cardiac arrest.  Primary aspects of BLS include immediate recognition of sudden cardiac arrest and activation of the emergency response system, early cardiopulmonary resuscitation, and rapid defibrillation with an automated external defibrillator.

Evaluation for Response

Check Child's Responsiveness
  • Quickly check for the "signs of life": normal breathing, coughing or spontaneous movement of the child
  • Gently stimulate the child
    • Do not shake child if spinal cord injury is suspected
  • Ask loudly "Are you all right?"


Assess Child & Get Help

Responsive Child

  • Allow the child to remain in the most comfortable position
  • Check condition
  • If alone, get help or if available, send someone for help
  • Reassess regularly

Unresponsive Child

  • Shout for help
  • Leave child in present position if able to assess
  • If unable to assess in present position, turn child on to his back
    • Roll child as a unit so head, shoulders & torso move together without causing the body to twist
  • If head or neck injury is suspected, move the child only if necessary

Assess Breathing & Circulation

Check child’s breathing

  • While evaluating for responsiveness, briefly check for signs of abnormal breathing or absence of breathing
    • Note that gasping is NOT normal breathing
  • Assessment should take <10 seconds

Check child for signs of circulation

  • Check for pulse
    • Infants: feel for brachial pulse
    • Children: feel for carotid or femoral pulse
  • Palpation of pulse is not the only determinant for the need to do chest compressions
  • No more than 10 seconds should be spent checking for circulation
    • If no pulse is felt or rescuer is not sure if pulse is present, begin chest compressions 
  • If a palpable pulse ≥60/minute is present but there is inadequate breathing, rescue breaths should be given
    • Reassess the pulse about every 2 minutes (but do so in <10 seconds)
  • If the pulse is <60/minute and with signs of poor perfusion (eg pallor, cyanosis, mottling) despite ventilation support, initiate chest compressions
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