Safety Training Seminars

BLS Infant 2-Person CPR - 2025 Guidelines Coming Soon

Bradycardia acls algorithm

Knowing how to respond in an emergency can make all the difference, especially when an infant is involved. Basic Life Support (BLS) for an infant requires specific techniques that differ from those used for adults. When two rescuers are present, the approach changes slightly, but the goal remains the same: to provide effective, life-saving care.

Performing CPR on an infant can be an intimidating thought. However, understanding the correct procedure for two-person CPR can significantly improve the quality of care and increase the chances of a positive outcome. A two-rescuer approach is more efficient, as it allows for continuous, high-quality chest compressions and effective ventilations while minimizing rescuer fatigue.

Key Differences in Infant CPR

Before diving into the steps, it’s important to understand what makes infant CPR unique. The anatomy of an infant requires modifications to ensure safety and effectiveness.

  • Compression-to-Breath Ratio: For two-person infant CPR, the ratio is 15 compressions to 2 breaths. This is different from the 30:2 ratio used in single-rescuer infant CPR and adult CPR. The higher frequency of breaths helps deliver more oxygen, which is crucial for infants who most often suffer from respiratory issues rather than cardiac events.
  • Compression Technique: The preferred method is the two-thumb encircling hands technique. This method provides better blood flow to the heart and creates more consistent compression depth.
  • Compression Depth: Compressions should be about 1.5 inches (4 cm) deep, which is approximately one-third the depth of the infant’s chest.
  • Pulse Check: For an infant, you should check for a pulse on the brachial artery. This is located on the inside of the upper arm, between the elbow and shoulder.

Step 1: Assess the Scene and the Infant

Your first priority in any emergency is to ensure the environment is safe for both you and the infant.

1. Ensure Safety

Quickly scan the area for any immediate dangers, such as traffic, fire, or other hazards. If the area is unsafe, move the infant to a safer location before starting any assessment or treatment.

2. Check for Responsiveness

Once the scene is safe, check if the infant is responsive. Gently tap the bottom of the infant’s foot and call out their name if you know it. Look for any movement or sound. Do not shake the infant.

3. Call for Help

If the infant is unresponsive, one rescuer should immediately call 911 or activate the emergency response system. If a mobile phone is available, put it on speakerphone so you can communicate with the dispatcher while performing CPR. The second rescuer should stay with the infant and prepare to begin CPR.

Step 2: Begin High-Quality CPR

With one rescuer calling for help, the other should immediately start the CPR sequence.

1. Check for Pulse and Breathing

Quickly check for breathing by observing the chest for any rise and fall. Simultaneously, check for the brachial pulse on the inside of the upper arm for no more than 10 seconds. If there is no pulse or breathing (or only gasping), begin CPR immediately.

2. Begin Compressions (Rescuer 1)

The first rescuer should position themselves to perform chest compressions.

  • Hand Placement: Use the two-thumb encircling technique. Wrap your hands around the infant’s torso so that your fingers support the back. Place both of your thumbs side-by-side on the center of the chest, just below the nipple line.
  • Compression Rate and Depth: Push hard and fast at a rate of 100 to 120 compressions per minute. The depth should be about 1.5 inches. Ensure you allow the chest to fully recoil between each compression. Perform 15 compressions.

3. Give Breaths (Rescuer 2)

After 15 compressions, the second rescuer gives two breaths.

  • Open the Airway: Gently tilt the infant’s head back to a neutral position and lift the chin (head-tilt/chin-lift maneuver). Be careful not to hyperextend the neck.
  • Deliver Breaths: Place your mouth over the infant’s mouth and nose to create an airtight seal. Give two gentle breaths, with each breath lasting about one second. Watch for the chest to rise with each breath. If the chest does not rise, reposition the head and try again.

Step 3: Use the Automated External Defibrillator (AED)

As soon as an AED is available, it should be used. One rescuer continues CPR while the other prepares the AED.

1. Attach the Pads

Turn on the AED and follow its voice prompts. Use pediatric pads if available. If not, adult pads can be used, but ensure they do not touch each other. Place one pad on the center of the infant’s chest and the other on the center of the back.

2. Follow Prompts

The AED will analyze the infant’s heart rhythm. It is crucial that no one touches the infant during this analysis.

3. Deliver Shock (If Advised)

If the AED advises a shock, ensure everyone is clear of the infant and press the shock button.

4. Resume CPR

Immediately after the shock is delivered, or if no shock is advised, resume CPR starting with chest compressions. Continue the 15:2 cycle.

Step 4: Switch Roles Effectively

To maintain the quality of CPR, rescuers must switch roles to prevent fatigue.

1. Coordinate the Switch

The switch should happen approximately every two minutes, which is about ten cycles of 15 compressions and 2 breaths. The rescuer performing compressions should call out the switch to ensure a smooth transition.

2. Ensure Minimal Interruption

The goal is to minimize any pause in chest compressions. The switch should be as quick as possible, ideally taking less than five seconds. While one rescuer moves to the head to provide breaths, the other moves to the chest to take over compressions.

3. Continue Until Help Arrives

Continue performing CPR, switching roles every two minutes, and following the AED prompts until emergency medical services arrive and take over, or until the infant begins to breathe and move on their own.

Train with Us and Be Prepared

Reading about BLS is an important first step, but hands-on training is essential to build the muscle memory and confidence needed to act effectively in a real emergency. At Safety Training Seminars, we offer comprehensive, American Heart Association-certified BLS courses that provide practical, in-person skills testing.

Our courses are designed for both medical professionals and the general public, with over 70 locations throughout California. As a woman-owned business established in 1989, we are committed to providing high-quality training at the lowest prices, guaranteed. You even receive your certification card on the same day you complete your class.

Don’t wait for an emergency to happen. Prepare yourself to save a life by booking a BLS, CPR, or First-Aid course with us today.