Pediatric cardiac arrest algorithm—basic

Last updated: June 27, 2023

Version control: Our ACLS, PALS & BLS courses follow 2020 American Heart Association Guidelines for CPR and ECC. American Heart Association guidelines are updated every five years. If you are reading this page after December 2025, please contact support@ACLS.net for an update. Version 2021.01.c

When responding to help a child, make sure to check for scene safety first. Check for responsiveness, shout for help, and activate EMS. If the child is breathing, stay with them and wait for help. If the child is not breathing and they have a pulse, provide a breath every 2–3 seconds and continue checking for a pulse every 2 minutes. Start chest compressions if the heart rate is < 60/min with signs of poor perfusion. Activate EMS if not already done.

If you witness the child is only gasping or not breathing and does not have a pulse, activate EMS and get an AED. If the child is found unresponsive, start CPR. A single rescuer should perform compressions at a rate of 30 to 2 breaths. Two rescuers should perform CPR at a ratio of 15 compressions to 2 breaths. Use the AED as soon as it arrives. After 2 minutes of CPR, activate EMS if not done already and get the AED. If a shockable rhythm is not detected start CPR and analyze the rhythm every 2 minutes. If a shockable rhythm is detected, give one shock and resume compressions immediately after the shock. Analyze the rhythm every 2 minutes and continue CPR until advanced life support arrives or the child becomes responsive.

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Written by , providing nurse training at Yale New Haven Health-Bridgeport Hospital since 2022. Previously in healthcare and education at Griffin Hospital, St. Vincent's College of Nursing and Sacred Heart University Medical Center.

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