A car pulls up to your ambulance with an unresponsive 1 year old female who is apneic and pulseless in the back seat. While your partner notifies dispatch and retrieves the AED, you should start CPR, providing:

• A. 2 ventilations followed by 30 compressions
• B. 30 chest compressions followed by 2 ventilations
• C. 1 ventilation every 5 seconds
• D. 5 cycles of 15 compressions and 2 ventilations

Answer: (B)

In pediatric cardiac arrest, the priority is to restore circulation quickly, so you start chest compressions first and then provide breaths. For a single rescuer performing CPR on a child, the standard sequence is 30 chest compressions followed by 2 ventilations, repeated in cycles. This keeps blood flowing to the brain and heart while you deliver breaths to oxygenate the blood.

So the best choice matches that 30:2 pattern: you push hard and fast (about 100–120 compressions per minute, compressing about one third of the chest depth), then pause briefly to give 2 breaths using a proper technique. You continue these cycles until an AED is ready to be used or the patient shows signs of life.

Starting with ventilations first delays circulation, which is why the option with breaths before compressions isn’t appropriate. A ventilation pace of one breath every 5 seconds isn’t aligned with the 30:2 cycle, and a 15:2 pattern is used when two rescuers are actively delivering compressions and breaths; at the moment you initiate CPR, 30:2 is the correct approach.