ProgniaPrognia
Back to Guidelines
European Respiratory SocietyPediatrics2026intermediate

2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 7. Pediatric basic life support.

Published by Korean Association of Cardiopulmonary Resuscitation · GRADE (Strong/Weak recommendations, level of certainty)

4Recommendations
71References
2Tables
4Figures
Read Full Guideline (Free)

Summary

AI-generated

The 2025 Korean Guidelines for Pediatric Basic Life Support detail updated, evidence-based practices for resuscitating infants and children. Key updates include the strong recommendation for all rescuers to use the two-thumb encircling hands technique for infant chest compressions, the implementation of pediatric early warning systems (PEWS) in hospitals, the approved use of AEDs by lay rescuers for children over 1 year of age, and alternating 5 back blows with 5 chest thrusts for choking infants.

pediatric basic life supportPBLSAHACPRAEDchokinginfantchild

Key Takeaways

  • 1
    Implement pediatric early warning systems (PEWS) to rapidly detect deterioration in hospitalized children.
  • 2
    All rescuers should use the two-thumb encircling hands technique for infant chest compressions, as it is superior to the two-finger technique.
  • 3
    Lay rescuers can and should use AEDs for nontraumatic OHCA in children aged 1 year or older.
  • 4
    Treat severe infant airway obstruction by alternating 5 back blows with 5 chest thrusts using the heel of one hand (abdominal thrusts are contraindicated).
  • 5
    Bag-mask ventilation is preferred over advanced airway insertion for pediatric OHCA.

What's New in This Version

Four major updates were introduced in 2025: (1) Implementation of pediatric early warning systems (PEWS) in hospitals; (2) Universal recommendation of the two-thumb encircling hands technique for infant chest compressions by all rescuers; (3) Suggestion for lay rescuer AED use in children aged 1 year or older with nontraumatic OHCA; (4) Specific guidance to alternate five back blows and five chest thrusts (using the heel of one hand) for infant foreign body airway obstruction.

Key Recommendations

MAJOR CHANGES IN THE 2025 PEDIATRIC BASIC LIFE SUPPORT GUIDELINES

  • rec_1

    It is suggested to implement pediatric early warning systems (PEWS) to facilitate early recognition of clinical deterioration in hospitalized children.

    weak recommendationEvidence: low certainty of evidenceprevention
  • rec_2

    For all rescuers (lay and healthcare providers), the two-thumb encircling hands technique is recommended for chest compressions in infants regardless of the number of rescuers. One-hand compression may be considered when this technique cannot be performed, or when the infant's body habitus and weight are close to those of a 1-year-old, but it is not recommended as the first choice.

    strong recommendationEvidence: very low certainty of evidenceintervention
  • rec_3

    For nontraumatic out-of-hospital cardiac arrest (OHCA) in children aged 1 year or more, the use of automated external defibrillators (AEDs) by lay rescuers is suggested.

    weak recommendationEvidence: very low certainty of evidenceintervention
  • rec_4

    Five back blows and five chest thrusts should be alternated to relieve foreign body airway obstruction in infants and repeated until the foreign body is expelled or the infant becomes unresponsive; chest thrusts should be delivered using the heel of one hand.

    expert consensus recommendationintervention

PBLS FOR HEALTHCARE PROVIDERS

  • rec_5

    Bag-mask ventilation is more reasonable for ventilation in pediatric patients with OHCA compared to advanced airway insertion (endotracheal intubation or supraglottic airway).

    weak recommendationEvidence: very low certaintyintervention

Scope & Objectives

Clinical Topic

Pediatric Basic Life Support

Objectives

To provide updated, evidence-driven guidelines for pediatric basic life support, aiming to enhance bystander intervention, CPR quality, and survival with favorable neurologic outcomes.

Target Patient Population

Infants and children under 8 years of age

Diagnostic Criteria

Unresponsiveness with absent or abnormal breathing (e.g., gasping). For healthcare providers, additionally checking for a pulse within 10 seconds; starting compressions if pulse is absent or <60 beats/min with signs of poor perfusion.

Target Providers

Lay rescuersHealthcare providers

Patient Criteria & Setting

Therapeutic Area

Cardiopulmonary Resuscitation

Guideline Scope

PreventionDiagnosisTreatment

Care Settings

Out-of-hospitalIn-hospital

Special Populations

InfantsTrauma patientsDrowning victimsChildren requiring special medical assistanceChildren with tracheostomy

Evidence Grading

System: GRADE (Strong/Weak recommendations, level of certainty)

Safety & Contraindications

Contraindications

  • Abdominal thrusts are not performed in infants due to the high risk of internal organ damage.
  • Blind finger sweeps to remove a foreign body are contraindicated.
  • Routine use of cricoid pressure is not recommended.

Monitoring Guidance

Implement Pediatric Early Warning Systems (PEWS) to monitor vital signs like blood pressure, pulse, respiratory rate, temperature, oxygen saturation, and consciousness level for early warning of deterioration in inpatient settings.

Authors & Contributors

Jisook LeeDo Kyun KimJin-Tae KimJae Yoon NaBobae ParkSoo In JeongJune Dong ParkSung Phil ChungTae-Youn KimYoudong SohnGyuhong ShimYoung Hwa JungYunhee OhChun Song YounMi Jin LeeChang Hee LeeYoungbin JangYong Soo JangGyu Chong ChoKyoung-Chul ChaJu Sun HeoSung Oh Hwang

Guideline Features

Dosing informationFlowcharts includedMultidisciplinary

Learning Context

Difficulty

intermediate

Learning Paths

Pediatric BLSCPR TechniquesAutomated External DefibrillatorsAirway Obstruction ManagementPediatric Early Warning Systems