BLS Healthcare Provider Pediatric Cardiac Arrest Algorithm for the Single Rescuer—2015 Update

This flowchart shows the BLS Healthcare Provider Pediatric Cardiac Arrest Algorithm for the Single Rescuer, as updated in 2015. It begins at the top with a green box that says, “Verify scene safety.” From here, an arrow points downward to an orange box that states, “Victim is unresponsive. Shout for nearby help. Activate emergency response system via mobile device (if appropriate).” The next arrow leads to a red hexagon. It says, “Look for no breathing or only gasping and check pulse (simultaneously.)” It then asks, “Is pulse definitely felt within 10 seconds?” From here, the flowchart branches in three directions. If the answer to the question is that the patient is breathing normally and has a pulse, follow the arrow to the left. A green box says, “Activate emergency response system (if not already done). Return to victim and monitor until emergency responders arrive.” If the answer is that the patient is not breathing normally and has a pulse, follow the arrow to the right. This green box contains the following text: “Provide rescue breathing: 1 breath every 3 to 5 seconds, or about 12 to 20 breaths per minute.
  • Add compressions if pulse remains less than or equal to 60 beats per minute with signs of poor perfusion.
  • Activate emergency response system (if not already done) after 2 minutes.
  • Continue rescue breathing; check pulse about every 2 minutes. If no pulse, begin CPR. (Go to “CPR” box.)”
If the answer is that the patient is not breathing or only gasping and does not have a pulse, follow the arrow downward to another red hexagon. It asks the question, “Witnessed sudden collapse?” From here, there are two branches. If the answer is “Yes,” follow the arrow to the right. A green box says, “Activate emergency response system (if not already done), and retrieve A.E.D. or defibrillator. From here, an arrow points down and to the left to the CPR box mentioned earlier. This blue box states: “1 rescuer: Begin cycles of 30 compressions and 2 breaths. (Use 15-to-2 ratio if second rescuer arrives.) Use A.E.D. as soon as it is available.” If the answer to the question, “Witnessed sudden collapse?” is “No,” an arrow leads directly to the CPR box. The CPR box points to an orange box below. It states, “After about 2 minutes, if still alone, activate emergency response system and retrieve A.E.D. (if not already done.)” Follow the next arrow downward to another red hexagon, which says, “A.E.D. analyzes rhythm. [Is it a] shockable rhythm?” If the answer is “Yes,” follow the arrow down to the left to the blue box that instructs: “Give 1 shock. Resume CPR immediately for about 2 minutes (until prompted by A.E.D. to allow rhythm check). Continue until A.L.S. providers take over or victim starts to move.” If the answer is “No,” follow the arrow down to the right to the blue box that states: “Resume CPR immediately for about 2 minutes (until prompted by A.E.D. to allow rhythm check.) Continue until A.L.S. providers take over or victim starts to move.” Whether the answer was “Yes” or “No,” these boxes point back to the red hexagon that says, “A.E.D. analyzes rhythm. [Is it a] shockable rhythm?” This figure is copyright 2015 by the American Heart Association.