Adult Basic Life Su ort Algorithm for Healthcare Providers
Verify scene safety.
• Check for responsiveness.
• Shout for nearby help.
• Activate emergency response
system via mobile device
(if appropriate).
• Get AED and emergency equipment
(or send someone to do so).
Normal No normal • Provide rescue breathing,
breathing, breathing, 1 breath every 6 seconds or
Look for no breathing
pulse felt pulse felt 10 breaths/min.
Monitor until or only gasping and check
• Check pulse every 2 minutes;
emergency pulse (simultaneously).
if no pulse, start CPR.
responders arrive. Is pulse definitely felt
• If possible opioid overdose,
within 10 seconds?
administer naloxone if
available per protocol.
No breathing
or only gasping,
pulse not felt
By this time in all scenarios, emergency
response system or backup is activated,
and AED and emergency equipment are
retrieved or someone is retrieving them.
Start CPR
• Perform cycles of 30 compressions
and 2 breaths.
• Use AED as soon as it is available.
AED arrives.
Check rhythm.
Shockable rhythm?
Yes, No,
shockable nonshockable
• Give 1 shock. Resume CPR • Resume CPR immediately for
immediately for 2 minutes 2 minutes (until prompted by AED
(until prompted by AED to allow to allow rhythm check).
rhythm check). • Continue until ALS providers take
• Continue until ALS providers take over or victim starts to move.
over or victim starts to move.
© 2020 American Heart Association
Pediatric Basic Life Support Algorithm for Healthcare Providers—Single Rescuer
Verify scene safety.
• Check for responsiveness.
• Shout for nearby help.
• Activate the emergency response system
via mobile device (if appropriate).
Normal No normal • Provide rescue breathing,
breathing, breathing, 1 breath every 2-3 seconds,
Look for no breathing or about 20-30 breaths/min.
Monitor until pulse felt or only gasping and check pulse felt
• Assess pulse rate for no
emergency pulse (simultaneously). more than 10 seconds.
responders arrive. Is pulse definitely felt
within 10 seconds?
Yes HR <60/min No
with signs of poor
perfusion?
No breathing
or only gasping, Start CPR. • Continue rescue
pulse not felt breathing; check
pulse every 2
minutes.
• If no pulse, start
CPR.
Yes Activate emergency response
Witnessed system (if not already done),
sudden collapse? and retrieve AED/defibrillator.
No
Start CPR
• 1 rescuer: Perform cycles of
30 compressions and 2 breaths.
• When second rescuer arrives,
perform cycles of 15 compressions
and 2 breaths.
• Use AED as soon as it is available.
After about 2 minutes, if still alone, activate
emergency response system and retrieve AED
(if not already done).
Check rhythm.
Shockable rhythm?
Yes, No,
shockable nonshockable
• Give 1 shock. Resume CPR • Resume CPR immediately for
immediately for 2 minutes 2 minutes (until prompted by AED
(until prompted by AED to allow to allow rhythm check).
rhythm check). • Continue until ALS providers take
• Continue until ALS providers take over or the child starts to move.
over or the child starts to move.
© 2020 American Heart Association
Pediatric Basic Life Support Algorithm for Healthcare Providers—2 or More Rescuers
Verify scene safety.
• Check for responsiveness.
• Shout for nearby help.
• First rescuer remains with the child.
Second rescuer activates emergency
response system and retrieves the
AED and emergency equipment.
Normal No normal
breathing, Look for no breathing breathing, • Provide rescue breathing,
Monitor until pulse felt or only gasping and check pulse felt 1 breath every 2-3 seconds,
emergency pulse (simultaneously). or about 20-30 breaths/min.
responders arrive. Is pulse definitely felt • Assess pulse rate for no
within 10 seconds? more than 10 seconds.
Yes HR <60/min No
with signs of poor
perfusion?
No breathing
or only gasping,
pulse not felt
Start CPR. • Continue rescue
breathing; check
pulse about
every 2 minutes.
• If no pulse, start
CPR.
Start CPR
• First rescuer performs cycles of
30 compressions and 2 breaths.
• When second rescuer returns,
perform cycles of 15 compressions
and 2 breaths.
• Use AED as soon as it is available.
Check rhythm.
Shockable rhythm?
Yes, No,
shockable nonshockable
• Give 1 shock. Resume CPR • Resume CPR immediately for
immediately for 2 minutes 2 minutes (until prompted by AED
(until prompted by AED to allow to allow rhythm check).
rhythm check). • Continue until ALS providers take
• Continue until ALS providers take over or the child starts to move.
over or the child starts to move.
© 2020 American Heart Association
Summary of High-Quality CPR
Components for BLS Providers
Infants
Adults and Children
Component (age less than 1 year,
adolescents (age 1 year to puberty)
excluding newborns)
Verifying scene safety Make sure the environment is safe for rescuers and victim
Recognizing cardiac arrest Check for responsiveness
No breathing or only gasping (ie, no normal breathing)
No definite pulse felt within 10 seconds
(Breathing and pulse check can be performed simultaneously in less than 10 seconds)
Activating emergency If a mobile device is available, phone emergency services (9-1-1)
response system
If you are alone with no Witnessed collapse
mobile phone, leave Follow steps for adults and adolescents on the left
the victim to activate the Unwitnessed collapse
emergency response Give 2 minutes of CPR
system and get the AED
Leave the victim to activate the emergency response system
before beginning CPR
and get the AED
Otherwise, send
Return to the child or infant and resume CPR;
someone and begin CPR
use the AED as soon as it is available
immediately; use the AED
as soon as it is available
Compression-ventilation 1 or 2 rescuers 1 rescuer
ratio without advanced 30:2 30:2
airway 2 or more rescuers
15:2
Compression-ventilation Continuous compressions Continuous compressions at a rate of 100-120/min
ratio with advanced airway at a rate of 100-120/min Give 1 breath every 2-3 seconds (20-30 breaths/min)
Give 1 breath every
6 seconds (10 breaths/min)
Compression rate 100-120/min
Compression depth At least 2 inches (5 cm)* At least one third AP At least one third AP
diameter of chest diameter of chest
Approximately 2 inches (5 cm) Approximately 1½ inches (4 cm)
Hand placement 2 hands on the 2 hands or 1 hand 1 rescuer
lower half of the (optional for very 2 fingers or 2 thumbs in the
breastbone (sternum) small child) on the center of the chest, just
lower half of the below the nipple line
breastbone (sternum) 2 or more rescuers
2 thumb–encircling hands in
the center of the chest, just
below the nipple line
If the rescuer is unable to
achieve the recommended
depth, it may be reasonable
to use the heel of one hand
Chest recoil Allow complete recoil of chest after each compression;
do not lean on the chest after each compression
Minimizing interruptions Limit interruptions in chest compressions to less than 10 seconds with a CCF goal of 80%
*Compression depth should be no more than 2.4 inches (6 cm).
Abbreviations: AED, automated external defibrillator; AP, anteroposterior; CCF, chest compression fraction;
CPR, cardiopulmonary resuscitation.
© 2020 American Heart Association
