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One & Two Rescuer BLS for Infants (0 to 12 Months Old)

One & Two Rescuer BLS for Infants (0 to 12 Months Old)

Updated on: September 30, 2025

Do you know that cardiac arrest strikes approximately 7,000 infants in the United States each year? In many of these cases, survival depends on a confident infant CPR rescuer who steps in before emergency responders arrive. Unlike adults, infants require specialized cardiopulmonary resuscitation (CPR) techniques that use gentler compressions, precise breathing, and adjusted ratios. That’s why knowing the one-rescuer and two-rescuer BLS algorithms is important. In this guide, we will walk you through everything related to the infant BLS algorithm for both one and two rescuer scenarios. 

Read More: Basic Airway Management in Children

 

What is BLS?

BLS, or Basic Life Support, is the foundation of emergency medical care. It’s what helps keep someone alive when their heart stops beating or they stop breathing. CPR, rescue breaths, and using an AED, that’s BLS in action. Healthcare providers, first responders, and even trained bystanders use it to stabilize a patient until advanced care arrives. BLS is about buying precious time when every second counts.

 

Why is Infant BLS Important?

Paramedics may reach in over 7 minutes but brain damage starts within just 4-6 minutes without oxygen. 

Source:  https://nypost.com/2025/09/17/us-news/nyc-response-times-for-life-threatening-emergencies-surge-in-troubling-trend/ 

Visit https://palscertification.com/ to know more

The infant BLS algorithm is important for persons involved in caring for infants to respond swiftly and confidently during life-threatening emergencies. This algorithm will help you learn: 

  • Open and maintain an airway
  • Provide rescue breaths
  • Deliver the chest compressions with an accurate rate and depth of chest compressions.
  • Use Automated External Defibrillators (AEDs)

 

When Do You Need to Perform Infant BLS?

Infant BLS can be necessary in various  life-threatening emergencies such as:

Cardiac Arrest

If the heart of an infant stops beating or the infant suddenly loses consciousness, then you must apply BLS techniques such as chest compression and rescue breaths. It will help ensure blood circulation and oxygenation until the experts reach the scene.

Choking

Babies are prone to choking emergencies. When an infant cannot breathe or cough as a result of obstructed air passages, you must administer back blows and chest thrusts to remove the lodged object and establish their normal respiration.

Respiratory Distress

Infants may develop breathing complications such as shallow or rapid breathing, wheezing, and gasping, which need infant BLS for the maintenance of their respiratory process. The procedures entail opening the airway and keeping it open, and giving adequate ventilation.

Drowning

During near-drowning or submersion accident emergencies, infant BLS can reinstate breathing and circulation. Rescue breaths and chest compression can be promptly initiated to stabilize the infant until expert help arrives.

Read More: Resuscitation Triangle Team Roles in ACLS

 

What are the Steps for Single vs. Two-Rescuer Infant CPR?

Performing CPR on infants under 12 months requires precision, calmness, and the right technique. Whether you are alone or working with another rescuer, the steps share similarities but differ in technique, compression-to-breath ratio, and teamwork. Below is a breakdown of how single vs. two-rescuer infant CPR compares.

Step Single Rescuer Infant CPR Two Rescuer Infant CPR
Scene Safety & Response Check the scene, tap the infant’s heels, and shout, “Are you okay?” If unresponsive, call 911 and place on a flat surface. Rescuer 1 checks safety and responsiveness while Rescuer 2 calls 911 and retrieves the AED.
Airway & Pulse Check Open the airway with a head-tilt chin-lift. Check the brachial pulse up to 10 seconds. Rescuer 2 opens the airway and checks pulse while Rescuer 1 prepares for compressions. Communicate findings clearly.
Compression Technique Use two fingers on the breastbone, pressing 1.5 inches deep. Use the thumb-encircling technique with hands wrapped around the chest for stronger compressions.
Compression-to-Breath Ratio Perform 30 compressions: 2 breaths at 100–120 compressions per minute. Perform 15 compressions: 2 breaths, allowing more frequent ventilation support.
Rescue Breaths Seal mouth and nose, give 2 breaths lasting 1 second each, with visible chest rise. Rescuer 2 provides breaths immediately after compressions. Clear coordination reduces pauses.
Fatigue Management Continue cycles alone, checking pulse every 2 minutes. Exhaustion may affect quality. Switch roles every 2 minutes to maintain high-quality CPR with minimal interruption.
AED Use Pause compressions briefly to attach and use AED when available. One rescuer continues compressions while the other operates AED and records interventions.

Safety Considerations for an Infant CPR Rescuer

Infant cardiac arrest emergencies often present differently from adult cases. So make sure to understand the infant vulnerabilities and learn how infant CPR differs from adult CPR.  Here’s what to keep in mind when you are performing infant CPR,

  • Recognize the Infant’s Anatomy: Infants have unique anatomical features, like smaller airways and fragile structures. 
  • Gentle Techniques: An Infant’s delicate structures need gentle techniques. Excessive force or pressure can cause rib fractures or other injuries.
  • Emotional Support: Provide emotional support to the parents/caregivers to maintain a calm and focused environment during an emergency.

Read More: Benefits of Getting PALS Certified

 

A Quick Checklist for Successful Resuscitation in Infants

While you are performing chest compressions or rescue breaths to an unconscious infant, how do you know that they are now conscious? Look out for the following signs to ensure a positive response to your resuscitation efforts:

  • Spontaneous breathing
  • Coughing or crying
  • Response to external stimuli, showing normal reflexes and movements.
  • Normal colour of skin (change from pale or bluish colour to pink or rose)
  • Improved heart rate

 

Common Mistakes to Avoid as an Infant CPR Rescuer

Even if you are an experienced infant CPR rescuer, it is common to make mistakes and face challenges during infant resuscitation. If you are in such a high-stress situation, you might make one or more of the following mistakes that could compromise your entire resuscitation efforts.

Incorrect Compression Technique

Compressing too fast, too shallow, or failing to allow complete recoil can reduce the CPR effectiveness. Similarly, leaning on the chest between compressions impairs venous return and reduces cardiac output.

Poor Hand Position 

If you are not trained, you might find it difficult to find the proper 1 or 2 rescuer infant CPR finger placement. Place your hand on the lower third of the breastbone, avoiding ribs or the upper chest. Use anatomical landmarks consistently to maintain proper positioning.

Complications in Ventilation 

Over-ventilation of infants can cause gastric distention due to excessive pressure. Deliver breaths slowly over 1 second, simultaneously watching for chest rise. Stop the ventilation once you see any chest movement.

Failures in Team Communication 

Unclear communication creates confusion during 2-rescuer infant CPR. Assign roles and responsibilities to each before beginning the CPR. Decide who compresses, who ventilates, and who communicates with emergency services, to ensure smooth handoffs every 2 minutes.

Lack of Progress Reporting 

Lack of updates about the condition of the victim can hinder your teamwork in two-rescuer CPR. Call out counts for chest compression for infant 2 rescuer, announce breath delivery, and report any changes in patient condition. 

Read More: How to Overcome Challenges During Pediatric Emergencies?

 

Protect Small Lives with Proper PALS Training!

Being an infant CPR rescuer requires dedication, practice, and continuous learning. Whether working alone or as part of a team, your ability to provide high-quality basic life support can dramatically impact survival outcomes. The difference between single and two-rescuer infant CPR lies in coordination, compression techniques, and ventilation ratios. Engage in regular practice to maintain your proficiency and build confidence to handle real emergencies.

You may never want to imagine yourself in a situation where a child’s life hangs in the balance. But emergencies don’t wait until you are ready. Sign up for online BLS certification and enhance your emergency response skills from the comfort of your home.

 

FAQs

1.  What is the difference between one and two-rescuer BLS for infants?

The main difference is in compressions and teamwork. One rescuer performs a 30:2 compression-to-breath ratio, whereas two rescuers switch to 15:2. With two rescuers, fatigue is reduced and compressions remain more consistent.

2. How deep should chest compressions be for infants during BLS?

Chest compressions for infants should be about 1.5 inches deep, or one-third the chest’s diameter. Proper depth ensures blood circulation without causing unnecessary injury. Always allow full chest recoil between compressions to keep blood moving effectively.

3. Why is teamwork important in two-rescuer infant BLS?

Teamwork keeps compressions strong and breaths effective. One rescuer focuses on compressions, whereas the other manages the airway and breathing. Switching every two minutes prevents fatigue, helping both rescuers maintain high-quality CPR until emergency professionals arrive.

4. When should an AED be used during infant BLS?

An AED should be used as soon as it is available. While one rescuer continues compressions, the other attaches the pads and follows prompts. Early defibrillation significantly increases survival chances in infant cardiac arrest cases.

5. How often should rescuers switch roles in two-rescuer infant BLS?

Rescuers should switch every two minutes, ideally within five seconds, to avoid interruptions. This prevents exhaustion, ensures high-quality compressions, and keeps oxygen and blood circulating effectively until advanced medical help arrives on scene.

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