Online CPR Certification Blog

When a child suddenly collapses, every second counts. Performing CPR (Cardiopulmonary Resuscitation) immediately can mean the difference between life and death. But CPR for children is not exactly the same as CPR for adults. The techniques, pressure, and breathing ratios all change because a child’s body is smaller, more delicate, and physiologically different.

This guide walks you through step-by-step CPR instructions for children aged 1–8, highlighting the crucial differences you must know to perform it safely and effectively.

Why CPR for Children Is Different

A child’s body is not a miniature version of an adult’s. Their bones, airways, and cardiovascular system require special care.

Key Differences Between Child and Adult CPR:

Factor	Adult	Child (1–8 years)
Compression Depth	At least 2 inches (5 cm)	About 2 inches (5 cm) — not deeper
Compression Method	Two hands	One hand (if small child) or two (if larger)
Rescue Breath Ratio	30:2	30:2 (single rescuer) or 15:2 (two rescuers)
Rescue Breath Strength	Full breath	Gentle breath — just enough to make chest rise
Cause of Arrest	Usually cardiac	Usually respiratory (choking, drowning, etc.)

Most adult cardiac arrests result from heart disease.
But in children, cardiac arrest often follows breathing problems, such as:

• Choking on food or toys
• Drowning
• Asthma attack
• Severe allergic reaction (anaphylaxis)
• Electrocution

That’s why, for children, airway and breathing are often as important as compressions.

Understanding the “Chain of Survival” for Children

Before diving into steps, it helps to know the Pediatric Chain of Survival, which outlines what to do in the right order:

• Prevent cardiac arrest (safety first, avoid choking hazards, monitor illness).
• Early CPR with effective compressions and breaths.
• Prompt activation of emergency medical services (911).
• Rapid defibrillation with an AED (if needed).
• Post-cardiac arrest care.

You are the first link in this chain — your quick response keeps oxygen flowing until professionals arrive.

Step 1: Check for Safety and Responsiveness

Always ensure the scene is safe for both you and the child before approaching.

• Check surroundings for hazards (traffic, electricity, water).
• Gently tap the child’s shoulder and shout:
  • “Are you okay?”
• Look for any signs of movement, crying, or breathing.

If the child is unresponsive, immediately move to the next step.

Step 2: Call for Help

If you’re not alone:

• Ask someone nearby to call 911 and get an AED immediately.
• Begin CPR right away.

If you’re alone:

• Perform 2 minutes of CPR first (about 5 cycles of 30 compressions and 2 breaths).
• Then call 911 and get an AED if available.

This is different from adults, where calling 911 comes before CPR.
In children, early CPR often makes a greater difference.

Step 3: Check Breathing and Pulse

• Open the Airway:
  • Gently tilt the head back and lift the chin to open the airway.
• Look, Listen, and Feel:
  • Look for chest movement.
  • Listen for breath sounds.
  • Feel for air against your cheek.
  • Do this for no more than 10 seconds.
• Check Pulse (if trained):
  • Feel for a pulse on the carotid artery (neck) or brachial artery (inside upper arm).

If there is no pulse, or if breathing is absent or abnormal (only gasping), start CPR immediately.

Step 4: Start Chest Compressions

Positioning:

• Place the child on a firm, flat surface (floor or ground).
• Kneel beside the chest.

Hand Placement:

• Place the heel of one hand on the center of the chest (lower half of the breastbone).
• If the child is larger or you can’t compress deep enough, use both hands (one over the other).

Technique:

• Press down about 2 inches (5 cm) deep.
• Keep your arms straight and shoulders directly over your hands.
• Push hard and fast — 100–120 compressions per minute.
• Allow the chest to fully recoil between compressions.

You can maintain rhythm to the beat of “Stayin’ Alive” or “Baby Shark” — both around 100–120 beats per minute.

Counting:

Perform 30 compressions, then 2 rescue breaths.

Step 5: Give Rescue Breaths

Rescue breaths are especially vital for children since most pediatric arrests start with breathing failure.

How to Give Rescue Breaths:

• Open the Airway (head tilt–chin lift).
• Pinch the Nose Closed.
• Cover the child’s mouth with yours to make a complete seal.
• Give 1 gentle breath over 1 second.
  • Watch for the chest to rise visibly.
• Give the second breath.

Each breath should be gentle and controlled — not forceful. Too much air can push air into the stomach and cause vomiting.

If the chest doesn’t rise:

• Reposition the head.
• Try again.
• If still not rising, continue compressions.

Step 6: Continue CPR Cycles

Continue the CPR pattern:

• 30 compressions → 2 breaths (if alone)
• 15 compressions → 2 breaths (if two rescuers are present)

Repeat for about 2 minutes (5 cycles) before checking the child again or calling for help if you’re alone.

Step 7: Use an AED (Automated External Defibrillator)

An AED can save a child’s life if the cardiac arrest is caused by an irregular heart rhythm.

Using an AED on a Child (Ages 1–8):

• Turn on the AED.
  • Follow the voice prompts.
• Apply Pads:
  • Use child pads if available.
  • If not, use adult pads (they’re still better than nothing).
• Pad Placement:
  • Place one pad on the center of the chest.
  • Place the second pad on the back between shoulder blades (anteroposterior position).
  • Pads should not touch each other.
• Follow Instructions:
  • The AED will analyze the rhythm and tell you whether to deliver a shock.
  • Make sure no one touches the child during analysis or shock.
• Resume CPR Immediately after each shock.

Continue cycles of CPR + AED until emergency professionals arrive.

Special Considerations During Child CPR

1. Breathing Comes First

Unlike adults, children often stop breathing before the heart stops.
That’s why rescue breaths are crucial for pediatric CPR.

2. One-Hand Compression

Children’s bones and ribs are more flexible and delicate.
For most kids aged 1–8, use one hand to prevent injury — unless you can’t achieve enough depth.

3. Shorter Cycles Before Calling 911 (If Alone)

If you’re alone, give 2 minutes of CPR first, then call for help.
This ensures oxygen is circulating before you leave to get assistance.

4. Avoid Overventilation

Too much air can cause gastric inflation and vomiting, increasing the risk of aspiration.
Blow gently — just enough to make the chest rise.

5. AED Pad Size

Always use pediatric pads for smaller children when possible.
If unavailable, adult pads may be used, but they must not overlap.

Common Causes of Cardiac Arrest in Children

Understanding the causes can help you prevent emergencies before they occur.

• Choking (on food, toys, small objects)
• Drowning
• Severe asthma attack
• Electrocution
• Blunt chest trauma (sports injuries, accidents)
• Congenital heart defects
• Severe allergic reaction (anaphylaxis)
• Poisoning or overdose

Preventive awareness saves lives just as much as quick action does.

When to Stop CPR

Stop only when:

• The child starts breathing or moving.
• EMS arrives and takes over.
• An AED advises you to stop.
• You are physically exhausted and unable to continue.
• The scene becomes unsafe.

Never stop just because you feel unsure — even partial CPR is better than none.

When to Check the Pulse (Advanced Rescuers)

If you are CPR-trained, check the pulse for no more than 10 seconds:

• Brachial artery (inside upper arm)
• Carotid artery (neck)

If no pulse or you’re unsure, start compressions immediately.

Rescue Breathing for a Child (If Pulse Is Present)

If the child has a pulse but isn’t breathing:

• Give 1 rescue breath every 3–5 seconds (about 12–20 per minute).
• Recheck the pulse every 2 minutes.
• If the pulse disappears, start full CPR immediately.

Real-Life Example: A Father’s Quick Action Saves His Son

At a neighborhood pool, a 6-year-old boy was found unresponsive at the water’s edge. His father, a CPR-trained volunteer firefighter, quickly checked for breathing — none.

He immediately began rescue breaths and chest compressions while his friend called 911. Within two minutes, the boy started gasping and coughing up water.

Paramedics arrived moments later, stabilized him, and transported him safely to the hospital. Doctors confirmed: The father’s CPR saved his son’s life.

This story highlights the importance of knowing child-specific CPR — and acting fast without hesitation.

Good Samaritan Laws: You’re Protected

Many people hesitate to perform CPR out of fear of being sued.
However, Good Samaritan Laws exist in most countries and U.S. states to protect individuals who act in good faith during emergencies.

As long as you:

• Act responsibly,
• Don’t expect payment, and
• Stay within your level of training,

You are legally protected when performing CPR.

Psychological Readiness: Staying Calm During Child Emergencies

Performing CPR on a child can be emotionally overwhelming.
But remember:

• You are the child’s best chance of survival.
• Even imperfect CPR is better than doing nothing.
• Dispatcher assistance is available — 911 operators will guide you step by step.

Take deep breaths, focus on the process, and keep compressions going.

How Dispatcher-Assisted CPR Helps

If you call 911, the dispatcher can:

• Help confirm cardiac arrest.
• Guide you through compressions and rescue breaths.
• Count the rhythm for you.
• Advise on AED usage.

Studies show dispatcher-guided CPR significantly increases survival rates, even in children.

Preventing Pediatric Cardiac Arrests

Prevention is always better than rescue.
Here are key prevention strategies:

• Supervise children around water — pools, bathtubs, lakes.
• Avoid small choking hazards — nuts, grapes, toys with small parts.
• Teach kids about safety — electricity, heights, roads.
• Manage chronic illnesses — asthma, allergies, heart defects.
• Learn first aid and CPR as a family or community.

Being proactive reduces the chances of ever needing CPR.

Common CPR Mistakes to Avoid

• Forgetting to Call for Help — Always activate EMS early.
• Too Forceful Compressions — Avoid pressing more than 2 inches deep.
• Inadequate Rescue Breaths — Blow gently; do not overinflate.
• Poor Chest Recoil — Let the chest fully rise between compressions.
• Stopping Too Soon — Continue until help arrives or the child recovers.
• Skipping AED Use — AEDs are safe for kids and save lives.

After the Emergency: Post-Event Support

After performing CPR, you might feel shaken or anxious — especially if it involves a child.
It’s normal to experience emotional stress. Consider:

• Talking with counselors or support groups.
• Attending debrief sessions if available.
• Refreshing your CPR skills to reinforce confidence.

Remember: You did something extraordinary — you acted when it mattered most.

Conclusion

Performing CPR on a child is one of the most powerful life-saving actions a person can take. The key differences — gentle compressions, smaller breaths, and faster response — are essential to prevent harm while giving the best chance for recovery.

Quick Recap: Child CPR Steps

• Check for responsiveness and breathing.
• Call 911 (after 2 minutes of CPR if alone).
• Begin chest compressions (1 or 2 hands, 2 inches deep).
• Give 2 gentle rescue breaths.
• Use an AED as soon as available.
• Continue cycles of CPR until help arrives or the child revives.

Your quick action can turn tragedy into hope.