Administering CPR to Adults and Children
The CPR procedure for children between 1 and 8 years old is the same as for adults.
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Check for consciousness
Ask the victim, "are you ok?" to check for consciousness. Try tapping on the shoulders to stimulate the victim. If the victim is truly not breathing and requires CPR, continue with the sequence.
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When to Activate EMS
If the victim is unconscious, call 911 or ask someone else to call before performing CPR. Even if you perform high-quality CPR on the spot, getting paramedics to the scene as quickly as possible is crucial. If possible, ask a bystander to look for an AED.
If alone, call 911 first before performing CPR on adult victims.
For pediatric patients:
- If collapse is un-witnessed: Perform 2 minutes of CPR first, then call the emergency response team and bring an AED to the patient.
- If collapse is witnessed: Call the emergency response team and bring an AED first, then start CPR.
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Pulse and Breathing
While waiting for the emergency medical team, check the breathing and pulse for about 10 seconds. If the breathing is normal, put the victim in the recovery position and wait for the responders to arrive. If the victim has no pulse and you do not hear breathing or only hear a few gasps, begin CPR immediately.
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- If the adult victim has a pulse but not breathing, provide rescue breathing only
- If the adult victim doesn't have a pulse, begin CPR starting with chest compressions.
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Begin CPR
Begin 5 cycles of CPR, starting with chest compressions: 1 cycle of CPR is 30 compressions to 2 rescue breaths (30:2). You should provide compressions at a rate of 100–120 compressions per minute.
Chest Compressions
Place the victim on their back on a firm, flat surface. Begin with 30 chest compressions at a rate of at least 100-120 compressions per minute. It may help count the compressions aloud as they are administered to keep track of progress.
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- For adult victims, the compressions should be 2-2.4 inches deep.
- For child victims, the compressions should be 1/3 the chest diameter or about two inches deep.
Allow the chest to recoil after each compression.
Chest Compression Fraction:Â The total percentage of resuscitation time during cardiac arrest. Try to minimize the interruptions in chest compressions. You must target at least 60 percent chest compression fraction goal.
Rescue Breathing
- Open the victim's airway by tilting the head back and lifting the jaw. This lifts the victim's tongue from the back of the throat, allowing air to pass into the lungs.
- Look into the victim's mouth and remove any visible obstructions.
- Position the face shield or other protective device if one is available.
- Pinch the victim's nostrils closed to prevent air from escaping.
- The rescuer should take a deep breath and position his mouth around the victim's mouth. The rescuer uses his lips to form a seal around the victim's mouth to prevent air from escaping.
- Blow into the victim's mouth until his chest rises. This takes about two seconds.
- Blow into the victim's mouth a second time, forming the second ventilation of the cycle.
- The entire ventilation sequence should take less than 10 seconds.
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Alternate between 30 compressions and 2 breaths. If multiple rescuers are present, take turns administering compressions to prevent fatigue, switching every two minutes. Administer the AED as soon as it is available. Repeat AED use after five cycles of CPR.
If the victim's chest does not rise during ventilations:
- Check the head position to ensure the airway is open. It may be necessary to tilt the head father back.
- Check for foreign material inside the mouth.
- Ensure that the nostrils are completely closed and that there is a tight seal around the victim's mouth.
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Infant CPR
Infant CPR has many similarities with child and adult CPR, but special accommodations must be made in hand position and compression depth due to the infant's small size. When administering infant CPR, use the same cycle of 30 compressions followed by 2 breaths.
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Check for Consciousness
Flick the bottom of the infant's foot to elicit a response. This takes the place of tapping the shoulder of an older person.
If the infant is unresponsive and you are alone:
- If collapse is un-witnessed, perform 2 minutes of CPR, then call the emergency response team and bring an AED to the patient.
- If collapse is witnessed, call the emergency response team and bring an AED, then start CPR.
If there are two or more rescuers:
Have someone near call the emergency response team and bring the AED, and you stay with the infant.
Place the patient supine on a hard flat surface and feel for the brachial or femoral pulse (Do not check for more than 10 seconds). Watch for abnormal breathing or gasping.
If the infant has a pulse but not breathing: Give Rescue Breathing only
- Give 12-20 breaths per minute.
- Recheck the pulse every 2 minutes.
- Use a barrier device if available.
- Each rescue breath should be small and last approximately 1 second.
- Watch for chest rise.
- Allow time for the air to expel from the patient.
If the infant doesn't have a pulse: Begin 5 cycles of CPR.
Hand Position
Use the two-thumb encircling hands technique or heel of one hand; the two-finger technique is no longer recommended in 2025 due to lower effectiveness.
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- Chest Compressions should be at least 1.5 inches or 1/3 of the infant's chest depth.
- Provide 100 to 120 compressions per minute. This is 30 compressions every 15 to 18 seconds.
- Push hard and fast.
- Allow for full chest recoil.
- Only allow minimal interruptions to the chest compressions.
- Standard CPR with an advanced airway: Give 12-20 rescue breaths per minute
For a Single Rescuer: 1 cycle is 30 chest compressions to 2 rescue breaths
For Two Rescuers: 1 cycle is 15 chest compressions to 2 rescue breaths. Switch rolls between compressor and rescue breather every 2 minutes or 5 cycles of CPR.
