How to Perform Child CPR

If you’ve ever watched people on TV perform CPR on an unconscious person, you probably have a general idea of how it works. But if an emergency occurred in real life, would you be ready to jump in?

To add another layer to that question...what if that person in danger was a young child? Performing CPR on a child whose heart has stopped could save their life. But you have to know when and how to do it. Children are smaller than adults, and you have to adjust your hand position and movements to account for that difference in size.

What Is CPR?

CPR stands for cardiopulmonary resuscitation, and is an attempt to revive someone when their heart stops beating. CPR keeps the blood flowing, which helps keep oxygen circulating.

There are two main versions of CPR: One type with both chest compressions and mouth-to-mouth rescue breathing, and a chest-compressions-only version.

The combined version is mainly designed for healthcare providers and people who are formally trained in CPR. But what if you’re not trained, or you don’t feel prepared to administer the full CPR?

In recognition of this possibility, the American Heart Association (AHA) created guidelines for general bystanders, saying they could try a chest compressions-only version of CPR on an adult. In fact, research suggests that people may feel more compelled to attempt CPR if they only have to do chest compressions. In those cases, the AHA urges people to call 911 and then administer hard, fast chest compressions while waiting for emergency services personnel to arrive.

However, it's important to note that the chest-compressions-only version was designed with untrained bystanders in mind—and only to be used on adults. CPR for children still includes the rescue breathing component, because a lack of oxygen flow can lead to permanent brain damage.

Before You Perform Child CPR

If you realize that a child is in crisis and CPR may be warranted, you might be tempted to just dive right in. While you don't want to wait too long, here are a few things to consider first.

Decide to Act

The first step to performing child CPR is simply knowing when to act. A collapsed and unresponsive child is one that requires CPR.

“The only wrong action is doing nothing,” says David Markenson, MD, chief medical officer for American Red Cross Training Services. “I would love to shout that from as loud a place as I could.”

Make Sure the Scene Is Safe

The physical environment should be safe for both you and the child. Make sure that you are out of harm's way, so you can focus all your energy on providing care.

Ask for help if you need it. The American Red Cross also suggests getting consent from the child’s parent or guardian if they’re on the scene, too.

Check the Child for Responsiveness

The American Red Cross suggests first shouting to get the child’s attention. Call their name if you know it. If you don’t get a response the first time, keep trying, and tap the child’s shoulder, too. But don't spend too much time on this; the Red Cross suggests checking for no longer than 10 seconds.

Call 911

If the child doesn’t respond after you’ve called and tapped them, call 911 immediately—or have someone else call while you attend to the child. In some parts of the country, the 911 dispatcher may be able to coach you through the process of giving CPR, says Dr. Markenson.

An Easy Way to Remember

To help yourself remember what to do if the situation is tense, Dr. Markenson suggests remembering these three Cs: check, call, and care.

·        Check on the person to see if they are unresponsive, and check your surroundings to make sure they’re safe.

·       Call 911 so you can get emergency services on the way.

·        Provide care in the way of CPR.

How to Perform Child CPR

Once you know that you and the unresponsive child are safe and that someone is calling 911, you can begin the actual process of CPR.

Put the Child in the Appropriate Position

Lay the child down on their back on a flat, firm surface. “Their chin should be off their chest,” adds Susan Fuchs, MD, a pediatrician in Chicago who helped develop the American Academy of Pediatrics’ First Aid/CPR/Choking chart.

Place Your Hands

If you’re going to be performing CPR on a very small child, use the heel of one hand. However, if the child is larger—closer to the older end of the 1-8 year age range—and with a little more room on their chest, you might want to use two hands, one on top of the other with the fingers interlaced.

Administer Chest Compressions

The rule of thumb is 30 chest compressions in a row. Put your hand (or hands) in the center of the child’s chest and push down hard and fast. The American Red Cross recommends trying to push the chest down about 1.5 inches at a rate of 100-120 times per minute.

Give Rescue Breaths

Give two rescue breaths directly into the child’s mouth. Each breath should last about one second. You may need to tilt the child’s head so the air gets into their airway. Watch for the chest to rise with each breath.

Repeat

This is perhaps the hardest part: you have to keep going. Perform another set of 30 chest compressions, followed by two rescue breaths. Repeat these steps until someone shows up to relieve you or the child begins to respond—whichever comes first.

Is Special Equipment Needed to Perform Child CPR?

You don’t need any special equipment to perform CPR—just your hands and a cool head. But the Red Cross does suggest the use of personal protective equipment if you have it, especially in the era of COVID-19. If you have a mask on hand, you could put it on the child before you administer any rescue breaths.

Also, if there’s an automated external defibrillator (AED) around, ask someone to bring it to you. And yes, it's safe to use an AED on a child between the ages of 0 and 8, according to the American Heart Association.

Should I Get CPR Certified?

When it comes to being prepared for an emergency, nothing can replace getting trained and
certified in CPR. Even if you’ve been trained in adult CPR, the training for child and infant CPR is different. So you would need to take a pediatric CPR course to receive specific certification for those skills.

You might start by checking with your local chapter of the American Red Cross to get a schedule of upcoming certification opportunities in your area.

If you’ve been certified in the past but your certification has expired, consider getting re-certified. Getting re-certified will help make sure your skills are up to date and you remember how to perform CPR correctly.

A Word From Verywell

Hopefully, you’ll never be in a situation where you need to perform CPR on an unresponsive child. But being prepared—and getting trained—are great ways to make sure you will be as ready as possible if such a situation were to arise.

“Even if you are not trained, do something to help the person,” Dr. Markenson says. “If you are afraid, call 911. Let them coach you and get help coming.”

“Don’t not do CPR,” says Dr. Fuchs. “Please do something.”