Cardiopulmonary resuscitation (CPR) is a series of steps to help a person who is not responding and has stopped breathing. CPR helps deliver oxygen rich blood to the body tissue when the body is not able to do this on its own.
Reasons for Procedure
CPR is given to a child who is not breathing. Reasons for this may include:
- Sudden cardiac arrest
- Cerebrovascular accident (bleeding in the brain)
- Electrical shocks and lightning strikes
- Severe infection
- Drug overdose
- Excessive bleeding
The outcome will depend on the cause and how soon effective CPR was initiated. Many are unable to regain a normal heartbeat after it has stopped.
It is possible that ribs will fracture or break during chest compressions. Other complications, like a puncture of a lung, are also possible.
People with weakened bones have a higher risk of fractures from CPR. However, there is greater risk of death if CPR is delayed or not done correctly.
What to Do
Prior to Procedure
When you see a child suddenly collapse, or find a child unconscious on the ground, immediately check to see if they are responsive. Tap the child and ask: “Are you OK?” If the child is unresponsive, follow these steps:
- If someone is with you, have that person call for emergency medical services right away. That person should also get the automatic external defibrillator (AED). An AED is a device that delivers electric shocks to the person's heart. If you are alone, do CPR for about 2 minutes before calling for medical help and getting the AED.
If the person is not breathing or only gasping, begin CPR by doing chest compressions:
- Place the palm of your hand on the lower half of their chest directly over the sternum. One or 2 hands may be used.
- Straighten your arms and lock your elbows. Begin pressing down in a straight motion. The compressions should be at least 2 inches deep.
- Push hard and fast at a rate of 100 compressions per minute.
- Allow the chest to rise completely between compressions.
- Minimize interruption between compressions.
If you are trained in CPR, give 2 rescue breaths after 30 compressions. To give rescue breaths:
- Open the airway by placing 1 hand on the forehead and lifting the chin with your other hand.
- Gently tilt the head backward. Pinch the child's nose and cover their mouth with yours.
- Breathe twice into their mouth until you see the chest rise. Breaths should be about 1 second each.
- After giving 2 rescue breaths, do 30 compressions. Continue the cycle of 2 breaths and 30 compressions.
- If you are not trained in CPR, continue doing the chest compressions without giving rescue breaths.
- If another person is present, take turns doing the chest compressions to avoid getting tired. If 2 people are giving CPR, the ratio of chest compressions to breaths is 15 compressions and 2 breaths.
Give CPR until the AED is brought to the scene or until:
- Medical help arrives
- It becomes unsafe to continue
- The child regains consciousness and is able to breathe
To use the AED:
- Turn the AED on.
- Attach the pads.
- Follow the prompts. If advised, deliver the shock. If the shock is not advised, the AED will tell you to resume CPR.
How Long Will It Take?
The length of time for CPR depends on the underlying causes and response time of medical help.
Will It Hurt the Child?
The child is unconscious when CPR is given. The procedure does not hurt. Some children may complain of soreness in the chest after regaining consciousness.
The emergency team will take over care when they arrive.
Children will need to be taken to the hospital for evaluation following CPR.
Call for Help
If a child is unresponsive and someone is with you, have that person call for emergency medical services right away. If you are alone, do CPR for about 2 minutes before calling for medical help.
Caring for Kids—Canadian Paediatric Society http://www.caringforkids.cps.ca
Heart and Stroke Foundation of Canada http://www.heartandstroke.com
2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support. Pediatrics. 2006;117(5):e989-e1004.
Bardy, G.H. A critic's assessment of our approach to cardiac arrest. New Engl J of Med. 2011;364(4):374-375.
Bush CM, Jones JS, et al. Pediatric injuries from cardiopulmonary resuscitation. Ann Emerg Med. 1996;28(1):40-44.
Heartsaver pediatric first aid CPR AED. American Heart Association website. Available at: http://www.heart.org/HEARTORG/CPRAndECC/CorporateTraining/HeartsaverCourses/Heartsaver-Pediatric-First-Aid-CPR-AED%5FUCM%5F303745%5FArticle.jsp. Accessed December 21, 2017.
Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.. Available at: http://circ.ahajournals.org/content/122/18%5Fsuppl%5F3/S640.full. Circulation. 2010;122(18 Suppl 3):S640-S656.
Topjian AA, Berg RA, et al. Pediatric cardiopulmonary resuscitation: advances in science, techniques, and outcomes. Pediatrics. 2008;122(5):1086-1098.
- Reviewer: EBSCO Medical Review Board Kari Kassir, MD
- Review Date: 11/2018
- Update Date: 12/20/2014