American Heart Association. Highlights of the 2020 American Heart Association Guidelines for CPR and ECC.cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf. Accessed April 20, 2021. Show
Duff JP, Topjian A, Berg MD, et al. 2018 American Heart Association focused update on pediatric advanced life support: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2018;138(23):e731-e739. PMID: 30571264pubmed.ncbi.nlm.nih.gov/30571264/. Easter JS, Scott HF. Pediatric resuscitation. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 163. Rose E. Pediatric respiratory emergencies: upper airway obstruction and infections. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 167. Topjian AA, Raymond TT, Atkins D, et al; Pediatric Basic and Advanced Life Support Collaborators. Part 4: Pediatric basic and advanced life support: 2020 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16_suppl_2):S469-S523. PMID: 33081526pubmed.ncbi.nlm.nih.gov/33081526/. Last reviewed on: 2/12/2021 Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 05/23/2022. This page provides the full detailed cardiopulmonary resuscitation (CPR) sequence for infants (babies under 1 year old) and children. It's highly recommended that every parent or carer goes on a first aid course, as it makes this process much easier to understand and remember. If a baby or child is unresponsive and not breathing normally, call 999 and start CPR straight away. When you call 999 for an ambulance, you should be given basic life-saving instructions over the phone, including advice about CPR. Child and baby CPR steps1. Ensure the area is safe
2. Check your child's responsiveness
3a. If your child responds by answering or moving
3b. If your child does not respond
If the child is under 1 year old:
If the child is over 1 year old:
If you think there may have been an injury to the neck, tilt the head carefully, a small amount at a time, until the airway is open. Opening the airway takes priority over a possible neck injury. 4. Check their breathingKeeping the airway open, look, listen and feel for normal breathing by putting your face close to your child's face and looking along their chest.
Look, listen and feel for no more than 10 seconds before deciding that they're not breathing. Gasping breaths should not be considered to be normal breathing. 5a. If your child is breathing normally
5b. If your child is not breathing or is breathing infrequently and irregularly
Rescue breaths for a baby under 1 year
Rescue breaths for a child over 1 year
5c. Obstructed airwayIf you have difficulty achieving effective breathing in your child, the airway may be obstructed.
6. Assess the circulation (signs of life)Look for signs of life. These include any movement, coughing, or normal breathing – not abnormal gasps or infrequent, irregular breaths. Signs of life presentIf there are definite signs of life:
No signs of life presentIf there are no signs of life:
7. Chest compressions: general guidance
Although the rate of compressions will be 100-120 a minute, the actual number delivered will be fewer because of the pauses to give breaths. The best method for compression varies slightly between infants and children. Chest compression in babies less than 1 year
Chest compression in children over 1 year
If you had no response to your call for help and you're alone, continue resuscitation for about 1 minute before trying to get help – for example, by calling 999. What is the best indicator of successful rescue breathing?Equal chest rise is an absolute marker of effectiveness of rescue breathing.
What is the rescue breathing rate for an infant?Pediatric Ventilation Rates
For infants and children with a pulse who are receiving rescue breathing or who are receiving CPR with an advanced airway in place, provide 1 breath every 2 to 3 seconds (20-30 breaths per minute).
How are rescue breaths performed differently on an infant?A child or infant's head should be tilted back more gently than an adult's when performing rescue breaths. This is because their airways are smaller and more delicate. Learning how to perform CPR properly could potentially save a life.
How should you check for an infant or child's breathing?Listen for sounds of breathing and see if you can feel their breath on your cheek. Watch to see if their chest moves. Do this for 10 seconds. If the baby is unresponsive, you need to call 999/112 for emergency help straight away and start baby CPR.
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