Cardiopulmonary resuscitation (CPR) is an emergency procedure that can increase the chances of survival for someone experiencing cardiac arrest. Proper execution of CPR varies depending on the age of the person needing assistance. Adapting CPR methods to different age groups ensures compressions and breaths are delivered appropriately. Understanding these age-specific differences is important for anyone who might find themselves in a life-threatening situation.
Age Classification for Child CPR
In CPR, a “child” is defined by specific age ranges established by medical guidelines. The American Heart Association (AHA) classifies a child as someone from 1 year of age up to the onset of puberty. Puberty is indicated by secondary sexual characteristics, such as breast development in females or underarm hair in males.
This classification helps differentiate CPR techniques for each age group. An infant is defined as a person younger than 1 year of age. An adult is considered anyone who has reached or is going through puberty. These age classifications help responders apply effective and appropriate CPR methods.
Key Differences in CPR by Age Group
The distinct physiological characteristics of infants, children, and adults necessitate variations in CPR techniques. Chest compressions are adjusted based on body size and bone structure. For children, compressions should be delivered to a depth of about 2 inches (5 cm) or approximately one-third the depth of the chest, using one or two hands depending on the rescuer’s size and the child’s build. Infant compressions require only two fingers, placed just below the nipple line, and should be about 1.5 inches (4 cm) deep, or one-third the chest’s depth. Adult compressions are deeper, aiming for at least 2 to 2.4 inches (5 to 6 cm).
The rate of compressions remains consistent across all age groups, at 100 to 120 compressions per minute. Rescue breaths also differ in technique. For infants, a rescuer covers both the infant’s mouth and nose with their mouth to deliver breaths. Children and adults receive mouth-to-mouth breaths, ensuring the chest visibly rises with each breath, with each breath lasting about 1 second.
For the ratio of compressions to breaths, a single rescuer performing CPR on an infant, child, or adult should use a 30:2 ratio (30 compressions followed by 2 breaths). When two or more trained rescuers are present for an infant or child, the recommended ratio shifts to 15:2. This emphasizes more frequent breaths for these younger age groups due to their common respiratory causes of cardiac arrest.
Important Considerations for CPR Responders
When faced with an emergency and uncertainty about a person’s age, responders should prioritize effective action. If there is doubt about whether a person is a child or an adult, it is recommended to use adult CPR techniques. This approach is safer because adult compressions are more forceful; applying them to an older child is less likely to cause harm than providing inadequate child CPR to an adult. For very small individuals where age is uncertain, using infant CPR techniques is the most appropriate starting point.
Activating emergency medical services promptly is an important step in any cardiac arrest situation. For unwitnessed collapses in children and infants, it is advised to perform about two minutes of CPR before calling for help, as respiratory issues are a common cause of arrest in these age groups. For witnessed collapses in any age group, calling for help immediately is important. Obtaining formal CPR training and certification is beneficial, as it provides the practical skills and confidence needed to respond effectively. These courses also cover the proper use of Automated External Defibrillators (AEDs), emphasizing that pediatric pads or specific settings are available for children, typically recommended for those under 8 years of age or weighing less than 55 pounds (25 kg). If pediatric pads are not available, adult pads can be used, ensuring they do not touch each other on the child’s chest.