Appropriate Rate for Delivering Rescue Breaths for PALS in 2022

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Appropriate Rate for Delivering Rescue Breaths for PALS in 2022

What Has Changed in Pediatric Advanced Life Support PALS Regarding Rescue Breaths?

The American Heart Association (AHA) has made some changes to their recommendations for PALS rescue breathing. This is a result of the PALS guidelines update released by the International Liaison Committee on Resuscitation (ILCOR) in 2019, and adopted by the AHA for 2020.

Since then, the importance of early initiation of CPR in Pediatric Advanced Life Support (PALS) has been re-emphasized for individuals considered “lay rescuers” or those who are not necessarily trained in CPR. Bystanders should not hesitate to start CPR regardless of training, as the risks of performing poorly are outweighed by the rate of success, effectively reducing the consequences that result from doing nothing at all. Early intervention is key in attempting to prevent cardiac failure and to potentially save a life.

The second change is that if a bystander can provide assistance, then they should assist in performing CPR on the infant or child victim with 15 chest compressions per 2 rescue breaths at a time, as opposed to the 30 compressions to 2 breaths ratio from previous guidelines. When alone, however, it is still standard for a single rescuer to provide 30 compressions per 2 breaths on victims of all ages.

What is the Appropriate Rate for Delivering Rescue Breaths in PALS?

The AHA recommends a rate for delivering rescue breaths as 1 breath every 2–3 seconds, or about 20–30 breaths per minute. This is to avoid over-oxygenating the patient and causing a condition called hyperoxia.

How Much Air Should be Delivered with Each Rescue Breath?

PALS Rescue breaths

Provide each breath over 1 second while watching for the child’s chest to rise. Do not give breaths too quickly as this may result in stomach distension, vomiting, and possible stomach content aspiration. Bag-mask devices are available as self-inflating and flow-inflating.

With advanced airway placement, note that chest compressions are continuous, and breaths are given every 2–3 seconds during CPR with the placement of an advanced airway in an infant or child. This is called giving asynchronous ventilations.

Where Do You Go to Learn About the Updated PALS 2020 Guidelines?

PALS rescue breaths
A group of healthcare professionals looking at a tablet screen.

In the Medical ProCerts PALS certification course, rescue breaths are just one lesson on how to manage potential cardiac arrest in pediatric victims.

Medical ProCerts has created an AHA-compliant PALS certification course and exam that is taken entirely online (learn more about the PALS exam here). The course materials include up-to-date algorithms, study materials, instructional videos and practice tests — all to help you prepare for the final exam. The exam is also online, and a successful completion means you are immediately issued your BLS certification provider card!

Sign up and get certified today!

Read more at: to certify or recertify in PALS today!

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