Basic life support for the child and infant

Cardiorespiratory arrest is uncommon in children and therefore nurses are unlikely to be involved in the practice of paediatric basic life support (BLS) (Bardai et al, 2011; Maconochie et al, 2015). Nonetheless, knowledge and skills in providing paediatric BLS remain essential, particularly given that the Nursing and Midwifery Council (NMC) standards of proficiency state:

‘All registered nurses must demonstrate the knowledge, skills and confidence to provide first aid procedures and basic life support.’

This article has used the Resuscitation Council UK (RCUK, 2015) evidence-based guidelines to discuss the practice of paediatric BLS as a way of updating practitioners.

The majority of cardiorespiratory arrests in children and infants are a result of respiratory insufficiency rather than cardiac problems (Cocks, 2006). Children and infants are at risk of becoming respiratory compromised and experiencing subsequent hypoxia for a number of reasons including birth asphyxia, inhalation of foreign bodies, bronchiolitis, asthma, convulsions, or neurological damage. Therefore, the order of delivering resuscitation differs between paediatrics and adults. In unresponsive adults, chest compressions should be performed before rescue breaths. In infants and children, respiratory insufficiency will subsequently cause cardiac arrest. Therefore, it is imperative that air, or where possible oxygen, is administered immediately through assisted breathing. The sequence for paediatric BLS follows a systematic approach: airway (A), breathing (B) and circulation (C).