National Health Care Provider Solutions™ is a Non-Profit 501 (c) organization empowered by the Disque Foundation™

BLS for Infants (0 to 12 months old)

Please purchase the course before starting the lesson.

BLS for both children and infants is almost identical. For example, if two rescuers are available to perform CPR, the breath to compression ratio is 15:2 for both infants and children (the ratio is 30:2 for all age groups if only one rescuer is present). The main differences between BLS for children and BLS for infants are:

  • Check the pulse in the infant using the brachial artery on the inside of the upper arm between the infant’s elbow and shoulder.
  • During CPR, compressions can be performed on an infant using two fingers (if only one rescuer) or with two thumb-encircling hands (Fig. 1) (if there are two rescuers and rescuer’s hands are big enough to go around the infant’s chest).
  • Compression depth should be 13 of the chest depth; for most infants, this is about 112 inches.
  • In infants, primary cardiac events are not common. Usually, cardiac arrest will be preceded by respiratory problems. Survival rates improve as you intervene with respiratory problems as early as possible. Remember that prevention is the first link in the Pediatric Chain of Survival!
  • If you witness a cardiac arrest in an infant, call EMS and get an AED just as you would in the BLS sequence for adults or children.
infant chest compressions
Fig. 1

One-Rescuer BLS for Infants

If you are the lone rescuer of an infant, do the following:

  1. Shake and shout at the victim to determine if they are responsive.
  2. Assess if they are breathing.
  3. If the child does not respond and they are not breathing (or if they are only gasping), yell for help. If someone responds, send the second person to call EMS and to get an AED.
  4. Feel for the infant’s femoral or brachial pulse for no more than 10 seconds. (Fig. 2)
  5. If you cannot feel a pulse (or if you are unsure), begin CPR by doing 30 compressions followed by 2 breaths. If you CAN feel a pulse but the rate is less than 60 beats per minute, begin CPR. This rate is too slow for an infant. To perform CPR on an infant: (Fig. 3)
    1. Be sure the infant is face up on a hard surface.
    2. Using two fingers, perform compressions in the center of the infant’s chest; do not press on the end of the sternum as this can cause injury to the infant.
    3. Compression depth should be about 1.5 inches and AT LEAST 100 per minute.
  6. After performing CPR for about 2 minutes (usually about 5 cycles of 30 compressions and 2 breaths). If help has not arrived, leave the infant to call EMS and get an AED.
  7. Use and follow AED prompts when available while continuing CPR until EMS arrives or patient condition normalizes.
feeling for infant femoral pulse
Fig. 2
infant CPR
Fig. 3

Two-Rescuer BLS for Children

If you are not alone with the infant:

  1. Shake and shout at the infant to determine if they are responsive.
  2. Assess if they are breathing.
  3. If the child does not respond and they are not breathing (or if they are only gasping), send the second person to call EMS and get an AED.
  4. Feel for the infant’s brachial pulse for no more than 10 seconds.
  5. If you cannot feel a pulse (or if you are unsure), begin CPR by doing 30 compressions followed by 2 breaths. If you CAN feel a pulse but the rate is less than 60 beats per minute, begin CPR. This rate is too slow for an infant.
  6. When the second rescuer returns, begin CPR by performing 15 compressions by one rescuer and 2 breaths by the second rescuer. If the second person can fit their hands around the infant’s chest, perform CPR using the two thumb-encircling hands method. Do not press on the bottom end of the sternum as this can cause injury to the infant.
  7. Compressions should be approximately 1.5 inches deep and at a rate of AT LEAST 100 per minute.
  8. Use and follow AED prompts when available while continuing CPR until EMS arrives or patient condition normalizes.
Back to: Pediatric Advanced Life Support (PALS) Course > PALS Basic Life Support