PEARS Child and Infant BLS — Questions and Answers

Question 1: When performing CPR on an infant, what is the correct hand position for chest compressions?

Two fingers on the center of the chest just below the nipple line
Heel of one hand on the lower half of the sternum
Both thumbs side by side on the center of the chest with hands encircling the torso (Correct answer)
Index and middle fingers on the upper sternum

Correct answer: Both thumbs side by side on the center of the chest with hands encircling the torso

The two-thumb encircling technique is preferred for infant CPR as it generates better coronary perfusion pressure.

Question 2: A child is found unresponsive and not breathing. You are alone. What is the correct sequence of actions?

Call 911 immediately before starting CPR
Perform 2 minutes of CPR before calling 911
Begin CPR immediately while someone else calls 911, or after 2 minutes if alone (Correct answer)
Give 5 rescue breaths before calling 911

Correct answer: Begin CPR immediately while someone else calls 911, or after 2 minutes if alone

For pediatric cardiac arrest, perform 2 minutes of CPR before leaving to call 911 if you are alone, since the most common cause is respiratory failure.

Question 3: What is the recommended compression-to-ventilation ratio when two rescuers are performing CPR on a child?

30:2
15:2 (Correct answer)
15:1
30:1

Correct answer: 15:2

Two-rescuer CPR for children uses a 15:2 ratio to provide more frequent ventilations given the respiratory cause of most pediatric arrests.

Question 4: During infant BLS, how deep should chest compressions be?

At least 1 inch (2.5 cm)
At least 1.5 inches (4 cm) (Correct answer)
At least 2 inches (5 cm)
At least 2.5 inches (6 cm)

Correct answer: At least 1.5 inches (4 cm)

Infant chest compressions should be at least 1.5 inches (approximately one-third the anteroposterior diameter of the chest).

Question 5: A 3-year-old has a pulse of 40 bpm and is unresponsive and apneic. What is the next action?

Begin chest compressions immediately at 30:2
Give rescue breaths and reassess in 2 minutes
Start CPR with compressions and breaths (Correct answer)
Apply an AED as soon as possible

Correct answer: Start CPR with compressions and breaths

A severely bradycardic, apneic, unresponsive child requires immediate CPR including both compressions and ventilations.

Question 6: When delivering rescue breaths to an infant, what is the correct technique?

Mouth-to-mouth only with head tilt-chin lift
Mouth-to-nose only to avoid overinflation
Mouth-to-mouth-and-nose with just enough air to make the chest rise (Correct answer)
Mouth-to-mouth with full adult tidal volume breaths

Correct answer: Mouth-to-mouth-and-nose with just enough air to make the chest rise

For infants, cover both the mouth and nose with your mouth and give small puffs just sufficient to see chest rise.

Question 7: What finding indicates that your rescue breath was effective during infant CPR?

The infant coughs
Visible chest rise (Correct answer)
Resistance felt when blowing
The infant's color improves immediately

Correct answer: Visible chest rise

Visible chest rise is the primary indicator that a rescue breath was delivered effectively and the airway is patent.

Question 8: A child is found unresponsive with a suspected foreign body airway obstruction. When should you perform a blind finger sweep?

After every 30 compressions
Only if you can see the object in the mouth during CPR (Correct answer)
Routinely after each set of compressions
As the first maneuver before compressions

Correct answer: Only if you can see the object in the mouth during CPR

Blind finger sweeps are not recommended in children; only remove a foreign body if it is clearly visible in the mouth.

Question 9: What rate should chest compressions be delivered during pediatric CPR?

60–80 compressions per minute
80–100 compressions per minute
100–120 compressions per minute (Correct answer)
120–140 compressions per minute

Correct answer: 100–120 compressions per minute

Current AHA guidelines recommend a compression rate of 100–120 per minute for both adult and pediatric CPR.

Question 10: A 5-year-old is choking and becomes unresponsive. What should you do next?

Continue abdominal thrusts until the object is expelled
Lower the child to the ground and begin CPR (Correct answer)
Perform 5 back blows and 5 chest thrusts
Call 911 and wait for EMS

Correct answer: Lower the child to the ground and begin CPR

When a choking child becomes unresponsive, lower them to the ground and begin CPR, looking for the object in the mouth before each set of breaths.

Question 11: Which term describes allowing the chest to fully recoil between compressions?

Active decompression
Full chest recoil (Correct answer)
Passive ventilation
Thoracic unloading

Correct answer: Full chest recoil

Full chest recoil between compressions is essential to allow venous return and effective cardiac filling.

Question 12: During two-rescuer infant CPR, when should the compressor and ventilator switch roles?

Every 1 minute
Every 2 minutes or 5 cycles of CPR (Correct answer)
Every 5 minutes
Only when the compressor tires

Correct answer: Every 2 minutes or 5 cycles of CPR

Rescuers should switch roles every 2 minutes (or every 5 cycles) to prevent fatigue and maintain adequate compression quality.

Question 13: An 8-month-old has a witnessed cardiac arrest. Two trained rescuers are present. What compression-to-ventilation ratio should they use?

30:2
15:2 (Correct answer)
15:1
20:2

Correct answer: 15:2

Two trained rescuers performing CPR on an infant or child should use a 15:2 ratio to increase ventilation frequency.

Question 14: What is the correct depth of chest compressions for a child (1 year to puberty)?

At least 1 inch (2.5 cm)
At least 1.5 inches (4 cm)
At least 2 inches (5 cm) (Correct answer)
At least 2.5 inches (6 cm)

Correct answer: At least 2 inches (5 cm)

For children, compressions should be at least 2 inches (5 cm) or approximately one-third the anteroposterior chest diameter.

Question 15: A child regains spontaneous circulation after CPR. What position should you place the child in if no spinal injury is suspected?

Supine with legs elevated
Recovery position (lateral recumbent) (Correct answer)
Sitting upright
Prone position

Correct answer: Recovery position (lateral recumbent)

The recovery (lateral recumbent) position maintains airway patency and allows drainage of secretions after return of spontaneous circulation.

Question 16: Which of the following is the most common cause of cardiac arrest in infants and children?

Ventricular fibrillation
Respiratory failure or airway obstruction (Correct answer)
Congenital heart disease
Electrolyte imbalance

Correct answer: Respiratory failure or airway obstruction

Unlike adults, pediatric cardiac arrest is most often caused by respiratory failure leading to hypoxia and subsequent cardiac arrest.

Question 17: During infant CPR, you are using the two-finger technique. Where exactly should you place your fingers?

Just above the xiphoid process on the lower sternum
On the center of the chest, just below the nipple line (Correct answer)
On the upper third of the sternum
On the left side of the chest over the heart

Correct answer: On the center of the chest, just below the nipple line

For the two-finger technique, place fingers on the center of the chest just below an imaginary line connecting the nipples.

Question 18: What action should you take if a second rescuer arrives while you are performing single-rescuer CPR on a child?

Continue 30:2 single-rescuer CPR with the new rescuer calling 911
Switch to 15:2 two-rescuer CPR with one rescuer on compressions and one on ventilations (Correct answer)
Have the new rescuer take over entirely while you rest
Continue current CPR while the second rescuer prepares the AED

Correct answer: Switch to 15:2 two-rescuer CPR with one rescuer on compressions and one on ventilations

When a second rescuer is available, switch to the two-rescuer 15:2 ratio for children to optimize compressions and ventilations.

Question 19: What is the correct head position for opening the airway in an infant?

Full hyperextension of the neck
Neutral or slightly extended 'sniffing' position (Correct answer)
Flexed chin-to-chest position
45-degree neck extension

Correct answer: Neutral or slightly extended 'sniffing' position

In infants, the airway is best opened with the head in a neutral or slightly extended 'sniffing' position; hyperextension can actually obstruct the airway.

Question 20: During CPR on a child, a provider should avoid which of the following?

Allowing full chest recoil between compressions
Leaning on the chest between compressions (Correct answer)
Compressing at a rate of 100-120 per minute
Minimizing interruptions to compressions

Correct answer: Leaning on the chest between compressions

Leaning on the chest between compressions prevents full recoil, which reduces venous return and decreases CPR effectiveness.

Question 21: A 3-year-old has a heart rate of 48 bpm and poor perfusion despite supplemental oxygen. What is the next step?

Observe and monitor for improvement
Begin CPR with chest compressions (Correct answer)
Give a fluid bolus immediately
Administer atropine before starting CPR

Correct answer: Begin CPR with chest compressions

A heart rate below 60 bpm with signs of poor perfusion despite oxygenation requires immediate CPR in children.

PEARS Child and Infant BLS

When performing CPR on an infant, what is the correct hand position for chest compressions?

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