Do you know the differences between infant, child, and adult CPR? The American Heart Association (AHA) conducts research on CPR outcomes of infants, children, and adults on an ongoing basis, so it’s important to stay up to date on how recommendations for CPR change over time. In this post we will cover the most updated key differences, including when to call 911, when to use the rescue breath approach, and much more. While this post will introduce you to some key concepts, we recommend taking a full course on CPR to equip yourself with the skills necessary to help save a life.
Your actions can make the difference between life and death in an emergency. Whether it’s a loved one or a stranger, it’s important to know the differences between adult, child and infant CPR.
CPR, or cardiopulmonary resuscitation, is a life-saving technique performed when someone’s heart has stopped beating. During a Sudden Cardiac Arrest (SCA), CPR is needed to get the blood pumping to the rest of the body, especially the lungs and brain, so that no further complications arise.
Because of COVID-19, many people are understandably concerned about coming into direct contact with others. This recent survey shows bystander reactions and the decline of people helping when CPR is required.
Avive seeks to help people understand the benefits of using CPR and an AED (Automated External Defibrillator), as well as the key differences between three types of CPR: infant, child, and adult.
Benefits of Learning/Knowing CPR
You never know when someone will suffer a cardiac arrest. It could happen in your home, office, or local restaurant. When you know how to perform CPR for adults and babies, you will have the training and confidence to act fast and potentially save a life.
Typically, CPR training also includes training on an AED. An AED is a portable medical device that sends an electric current through the body and restores the heart’s rhythm when it is in a chaotic, “shockable” rhythm, such as ventricular fibrillation. You can use an AED on a child (ages 1-8), but you must first check to see if the AED unit has a built-in attenuator. Some AED models might require separate child-sized electrode pads, so make sure to check with your AED manufacturer to learn what’s appropriate for your AED.
Organizations like the American Red Cross offer training for those interested in becoming CPR trained and certified. You don’t have to be a first responder or medical professional to know how to save someone’s life. Recent research indicates that even middle-school aged children can be effective at saving a life through hands-only CPR and using AEDs. Many companies will encourage, and sometimes even require employees to have CPR training, and we encourage all parents to know how to perform CPR in case of emergency.
Differences Between Infant, Child, and Adult CPR
It’s important to note that there are some differences in how to administer CPR, depending on the person’s age or size. Infants, Children, and Adults all have different requirements for life-saving techniques and performing CPR. For any emergency situation, always make sure the scene is safe for you to enter.
Adults may fall victim to Sudden Cardiac Arrest for any number of reasons. According to the American Heart Association, in 2015, emergency medical services (EMS) responded to roughly 350,000 instances of adults suffering cardiac arrest outside of a hospital in the United States. Only about 10% of these patients survive, and only about 8% survive with good functional status. In case of emergency,
1. Call 911
Once you conclude the scene is safe, initiate the emergency response system.
Survival from Sudden Cardiac Arrest depends on the quick response of people nearby. If you see someone collapse suddenly and they are not responsive, you need to immediately call 911.
Let’s say you didn’t see a person collapse, but you find someone who is unresponsive. In this case, you also need to immediately call 911.
If a person is not responding, don’t keep trying to wake them up – they will not and your fast response is critical for their survival. Shout for help. Otherwise, if you are alone, use your cell phone to call 911. If more than one person is available, one person should start CPR while the other person calls 911. If additional bystanders are present, a person can be delegated to assist with crowd control.
This video demonstrates how to check for responsiveness in an adult
2. Push - Perform Hands-Only CPR
Hands-Only CPR, even if it’s not performed perfectly, greatly increases a person’s chances of survival. Push hard and fast, trying to perform 100-120 compressions per minute.
One way to time your chest compression rate is to push with the beat of a song, such as “Stayin’ Alive” by the Bee Gees, or another song with a tempo of 100 to 120 beats per minute.
To administer chest compressions, overlap your hands (one on top of the other), lacing the fingers on your top hand between the fingers on your lower hand, and place them on the center of the person’s chest. Use the heel of your palm to apply pressure, going about two inches into the chest. Continue delivering compressions at the tempo mentioned above until you become too exhausted to continue and someone else can take over, someone brings an AED to the scene, or EMS personnel arrive. The American Red Cross recommends that bystanders perform hands-only CPR on adults.
While children are less likely to suffer SCA than adults, it isn’t rare. More than 20,000 infants and children experience cardiac arrest each year in the United States, and roughly 7,000 of those cases take place outside of a hospital.
Once you have identified the scene as safe, respond to children with the following steps:
1. Begin CPR
Any child that is unresponsive, not breathing normally, and not giving signs of life needs CPR immediately. Begin CPR without delay and do not spend time checking for a pulse. If someone is available to call 911 for you, designate them to do so. If you are alone, but have a cell phone on you, call 911 immediately. Otherwise, perform 5 cycles of CPR.
2. Call 911
Call 911 to report an emergency and get an AED (if possible)
In any situation, if a child is unconscious due to a blocked airway, do not poke your finger around in the child’s throat as this may do more harm, just clear their mouth as necessary.
3. Push - Begin CPR
The age and size of the child will determine the type of chest compressions you perform. It may be reasonable to use either a one or two handed technique, compressing the chest about 2 inches (5 cm). In prepubescent children, it is important not to exceed 2 inches. However, teenagers can receive compressions with a depth of up to 6 cm.
Like adults, children also need 100-120 compressions per minute.
4. Rescue Breaths
A Rescue Breath is a technique in which you breathe directly into a person’s mouth. You will first need to tip their head back slightly so that the air is pushed to their lungs.
And remember, a child’s lungs are not as big as an adult’s, so you don’t want to push too much air. The American Heart Association stresses the importance of rescue breaths when resuscitating children because asphyxial cardiac arrest from things like choking, asthma attacks, or anaphylaxis is more common in children than cardiac arrest from a heart condition. Make sure to pinch the child’s nose shut and form a complete seal over their mouth with your own to make sure the breaths go in.
For single-rescuer situations, the ratio is 2 breaths for every 30 compressions. For a two-rescuer situation, the rescue breath ratio is 2 breaths from one of the rescuers every time the other rescuer completes 15 compressions.
Infant CPR differs from adult or child CPR in various ways, and should be performed when responding to babies who are less than a year old. A one-year-old and above is considered a child for CPR.
Similarly to child CPR, starting compressions and rescue breathing immediately is of utmost importance. This is because, in children and infants, cardiac arrests are usually due to choking rather than a heart-related issue.
1. Check for Consciousness
Once you have deduced that the scene is safe, check the baby’s consciousness. Do not ever shake a baby to check for consciousness. Instead, tap their foot or stroke their arm for a response. You will want to apply just enough pressure that would typically wake them up from sleep.
2. Call 911
If an infant is not showing any signs of life, shout for help. Otherwise, if you are alone, use your cell phone to call 911.
3. Push - Begin CPR
Do not delay in starting 5 cycles of CPR. After 5 cycles, if you do not have a cell phone, go call 911 and retrieve an AED if you can.
4. Infant Chest Compressions
If an infant is not showing any signs of life, start CPR right away. If you are the only rescuer on the scene, use your two middle fingers on your dominant hand and push an inch and a half deep on their chest. If you have a second rescuer helping you, you can wrap your hands around the infant’s trunk and use your two thumbs to perform chest compressions. If you cannot reach an inch and a half of depth through these two approaches, you can try to do so gently with the heel of your hand. Once again, humming a tune with a tempo of 100 to 120 beats per minute, such as “Stayin’ Alive” will keep your tempo at the right pace.
5. Rescue Breaths
Like a child’s, an infant’s airway is very narrow. Do not tip their head back too far when giving a Rescue Breath.
Make a complete seal over the infant's mouth and nose by placing your mouth over both, then blow in for one second to make the chest clearly rise. Then, deliver two rescue breaths. As with children, you must provide 2 rescue breaths every 30 compressions if you are performing CPR on your own. If you are performing CPR with another person, make sure to deliver two rescue breaths every 15 compressions.
Take a look at some common questions we see about CPR.
At what age is a child eligible for infant CPR?
Infant CPR is performed on those less than 12 months old.