The Child BLS Megacode: A Comprehensive Guide to Saving Lives

In this comprehensive guide, we will teach you everything you need to know about the Child BLS Megacode. This lifesaving procedure is used to resuscitate infants who are not breathing or have a heartbeat.

We will discuss the steps involved in performing the Megacode. We will also provide a video demonstration of how to perform these procedures.

We highly recommend that all healthcare providers become familiar with this procedure, as it could one day save a life!

Table of Contents

Child Megacode Scenario

The following is a scenario in which you would use the Child BLS Megacode:

You arrive on a scene for a child (ages 13 months to the age of puberty) who is not breathing and no bystander CPR has been performed.

Demonstrate what you would do next

  1. Check for scene safety: If the scene is not safe, move the child prior to starting interventions
  2. Check responsiveness: Tap the shoulders of a child and shout “Are you okay?” Check for any kind of response.
  3. Activate the Emergency Response System: Call for help. If you are with someone, have them find an AED and call 911. If you are by yourself, perform a round of CPR then call for help and obtain an AED.
  4. Check for breathing: Look for visible chest rising and fall
  5. Check for a pulse: Palpate the carotid or femoral pulse for no more than 10 seconds.

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

Chest Compressions and Airway (CAB)

Child 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

Child Rescue Breaths

Give 2 breaths with a barrier device after each 30 chest compressions

  • 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 (if available) 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. If the person is under 8 years old, use the child pads if available. If child pads are not available, you may use adult pads. Place pads so they do not touch each other. One pad is placed on the chest and the other pad is placed on the back. Pads should sandwich the heart when placed appropriately. If the child is 8 years old or older, use the adult pads. Do not use child pads as the shock will be too low of a dose.
  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.

If 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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