CPR - young child (age 1 year to onset of puberty)

CPR is best done by someone trained in an accredited CPR course. The newest techniques emphasize compression over rescue breathing and airway management, reversing a long-standing practice.

All parents and those who take care of children should learn infant and child CPR if they have not already. See cpr.heart.org/en/course-catalog-search for classes near you.

Time is very important when dealing with an unconscious child who is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur as soon as 4 to 6 minutes later.

Machines called automated external defibrillators (AEDs) can be found in many public places and are available for home use. These machines have pads or paddles to place on the chest during a life-threatening emergency. They use computers to automatically check the heart rhythm and give a sudden shock if, and only if, that shock is needed to get the heart back into the right rhythm. When using an AED, follow the instructions exactly.

The procedures described in this article are not a substitute for CPR training.

There are many things that cause a child's heartbeat and breathing to stop. Some reasons you may need to do CPR on a child include:

• Choking
• Drowning
• Electrical shock
• Excessive bleeding
• Head trauma or other serious injury
• Lung disease
• Poisoning
• Suffocation

CPR should be done if the child has any of the following symptoms:

• No breathing
• No pulse
• Unconsciousness

1. Check for alertness. Shout the child's name if you know it. If not, you should shout, "ARE YOU OK"? If the child does not respond, tap the child's shoulder. See if the child moves or makes a noise. DO NOT shake the child. Spend no more than 10 seconds trying to get the child's attention.

2. If there is no response, shout for help. Tell someone to call 911 or the local emergency number and get an AED if available. Do not leave the child alone to call 911 or the local emergency number until you have done CPR for about 2 minutes.

3. Carefully place the child on its back. Place the child on a firm surface, if possible. If there is a chance the child has a spinal injury, two people should move the child to prevent the head and neck from twisting.

4. Give 30 chest compressions followed by 2 breaths:

• Stand or kneel next to the child.
• Place the heel of one hand in the center of the child's chest and the other hand on top of it with fingers interlaced.
• Position your body directly over your hands with your elbows locked and your shoulders in line with your hands.
• Give 30 chest compressions. Press down on the child's chest so that it compresses about 2 inches (5 cm). Let the chest rise completely after each compression. These compressions should be fast and hard with no pausing. Count the 30 compressions quickly: "1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off''.

5. Open the airway. Lift up the chin with one hand. At the same time, tilt the head by firmly pushing the forehead back with the other hand.

6. Look, listen, and feel for breathing. Place your ear close to the child's mouth and nose. Watch for chest movement. Feel for breath on your cheek.

7. If the child is not breathing:

• Cover the child's mouth tightly with your mouth.
• Pinch the nose closed.
• Keep the chin lifted and head tilted.
• Give 2 rescue breaths. Each breath should take about a second and make the chest rise. Allow the air to exit after each breath.

8. Use a chest compression rate of 100 to 120 per minute. Pauses in chest compressions should be less than 10 seconds. Children undergoing CPR should receive 2 breaths after every 30 chest compressions if there is a single rescuer. If there are two rescuers, the child should receive 2 breaths after every 15 chest compressions. Keep rechecking for breathing until help arrives.

9. Continue to give 30 chest compressions and 2 rescue breaths until:

• The child recovers.
• The AED is ready to use.
• Help arrives.
• You have performed 2 minutes of CPR (5 sets of 30 compressions and 2 breaths) and you are alone and need to call 911 or the local emergency number.

If the child starts breathing again, place them in the recovery position. To do this, start with the child lying on their back. Then, pull the arm closest to you so that it makes a right angle to their body with palm up. Fold their other arm and place it under their cheek closest to you. You'll have to hold it there. With your free hand, bend the person's right knee that's farthest from you to a right angle. Carefully roll the person onto their left side by pulling on the bent knee toward you. Their bent arm should be supporting the head, and their extended arm will stop you from rolling them too far. Make sure their bent leg is at a right angle. Keep checking for breathing until help arrives.

Avoid making the situation worse by following these tips:

• If you think the child has a spinal injury, pull the jaw forward without moving the head or neck. Do not let the mouth close.
• If the child has signs of normal breathing, coughing, or movement, do not begin chest compressions. Doing so may cause the heart to stop beating.
• Unless you are a health professional, do not check for a pulse. Only a health care professional is properly trained to check for a pulse.

Steps to take if you are with another person or if you are alone with a child:

• If you have help, tell one person to call 911 or the local emergency number while another person begins CPR.
• If you are alone, shout loudly for help and begin CPR. After doing CPR for about 2 minutes, if no help has arrived, call 911 or the local emergency number. You may carry the child with you to the nearest phone (unless you suspect a spinal injury).

Most children need CPR because of a preventable accident. The following tips may help prevent an accident:

• Teach your children the basic principles of family safety.
• Teach your child to swim.
• Teach your child to watch for cars and how to ride a bike safely, including wearing a helmet.
• Make sure you follow the guidelines for using children's car seats.
• Teach your child firearm safety. If you have guns in your home, keep them locked in an isolated cabinet.
• Teach your child the meaning of don't touch.

Never underestimate what a child can do. Assume the child can move and pick up things more than you think they can. Think about what the child may get into next and be ready. Climbing and squirming are to be expected. Always use safety straps on high chairs and strollers.

Choose age-appropriate toys. Do not give small children toys that are heavy or fragile. Inspect toys for small or loose parts, sharp edges, points, loose batteries, and other hazards. Keep toxic chemicals and cleaning solutions safely stored in childproof cabinets.

Create a safe environment and supervise children carefully, particularly around water and near furniture. Electrical outlets, stove tops, and medicine cabinets can be dangerous for small children.

Rescue breathing and chest compressions - child; Resuscitation - cardiopulmonary - child; Cardiopulmonary resuscitation - child

American Heart Association website. Highlights of the 2025 American Heart Association guidelines for CPR and ECC. cpr.heart.org/-/media/CPR-Files/2025-documents-for-cpr-heart-edits-posting/Resuscitation-Science/252500_Hghlghts_2025ECCGuidelines.pdf?sc_lang=en. Accessed February 10, 2026.

Cao D, Arens AM, Chow SL, et al. Part 10: Adult and pediatric special circumstances of resuscitation: 2025 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2025;152(16_suppl_2):S578-S672. PMID: 41122889 pubmed.ncbi.nlm.nih.gov/41122889/.

Joyner BL Jr, Dewan M, Bavare A, et al, eds. Part 6: Pediatric basic life support: 2025 American Heart Association and American Academy of Pediatrics guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2025 Oct 21;152(16_suppl_2):S424-S447. PMID: 41122891 pubmed.ncbi.nlm.nih.gov/41122891/.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.