The Adult BLS 2-Rescuer Megacode: How to Perform CPR and Use an AED

The BLS 2-Rescuer Megacode is a set of guidelines for how to provide CPR and use an AED. This code was developed by the American Heart Association and provides step-by-step instructions for rescuing someone who is experiencing cardiac arrest.

In this blog post, we will discuss the steps involved in performing CPR and using an AED.

We will also provide a video demonstration of how to perform these procedures.

Table of Contents

Adult 2-Rescuer Megacode Scenario

The following is a scenario in which you would use the Adult 2-Rescuer BLS Megacode:

You are two bystanders who witness an adult collapse. The person is unresponsive and not breathing.

Demonstrate what you would do next

  1. Check for scene safety: If the scene is not safe, move the person prior to starting interventions
  2. Check responsiveness: Tap the shoulders and shout, “Are you okay?”
  3. Activate the Emergency Response System: Have the second rescuer call for help and obtain an AED.
  4. Check for breathing: Look for visible chest rising and fall
  5. Check for a pulse: Place your fingers on the inside of the patient’s neck, just below the angle of the jaw. You will palpate the carotid pulse for no more than 10 seconds.

The person is unresponsive with no pulse or breathing. What are your next actions?

Chest Compressions and Airway (CAB)

Adult Compressions

Perform High-Quality Compressions

  • Hands should be placed on the lower half of the sternum
  • 30 compressions at a rate of 100 to 120 compressions per minute
  • Compresses at least 2 inches (5 cm)
  • Complete chest recoil after each compression

Adult Rescue Breaths

Give 2 breaths with a barrier device

  • Each breath should be given over 1 second
  • Visible chest rise and fall with each breath
  • resume compressions in less than 10 seconds

You will need to perform one to two rounds of high-quality CPR.

Automated External Defibrillator (AED)

Have the second rescuer begin compressions as the first rescuer performs the following steps below.

  1. Turn on the AED and follow the prompts
  2. Correctly attached pads and plug-in connector. Remove any barriers including medication patches, water, or clothing.
  3. Clear for AED analysis. Stop chest compressions. Call out “stand clear.”
  4. Push the analyze button and allow time for analysis.
  5. Deliver shock if recommended by AED.

Resume Compressions

Continue compressions immediately after the shock is delivered or if the AED does not recommend the shock.

Now that you have both rescuers, the first rescuer will take over for rescue breathing and the second rescuer will continue with chest compressions. You will switch roles every 5 rounds of compressions or every 2 minutes.


Your scenario has concluded.


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