Child Cardiac Arrest: CPR and AED Guidance (Ages 1–12)

Cardiac arrest in children is uncommon. When it does occur, it is usually caused by another medical emergency, most often a breathing problem, trauma, or an underlying illness, rather than a primary heart condition.

Your first priority is to assess the situation quickly and understand what may have happened.

Ensure the Scene Is Safe

Before approaching the child, always check that it is safe to do so. Look for any dangers that could harm you or the child.

If a parent, teacher, or guardian is nearby, ask for permission before intervening:

“Can I help your child?”

Check for Responsiveness

If the child appears unresponsive, speak to them directly. Even if they cannot reply, they may still be able to hear you.

Speak calmly and clearly:

“Hello, my name’s Keith, I’m a first aider. Can you hear me?”

If you know the child’s name, use it, as this can sometimes prompt a response.

If there is no response:

• Gently tap the child’s shoulder or collarbone
• Ask again, “Are you OK? Can you hear me?”

Call for Help

If the child remains unresponsive, shout for help immediately.

• If someone is with you, ask them to call 999 on speakerphone, leave the phone with you, and bring an AED if one is available.
• The emergency call handler will give step-by-step instructions and guide you through CPR if needed.

If you are alone, call 999 on speakerphone yourself and continue your assessment.

Check for Normal Breathing

• Open the airway using the head-tilt, chin-lift technique
• Briefly look inside the mouth for any obvious obstruction and remove it if visible
• Place one hand on the forehead and two fingers on the bony part of the chin, gently tilting the head back
• Open the mouth slightly and check again for any visible obstruction
• Look, listen, and feel for normal breathing for up to 10 seconds

You are looking for chest rise and fall, listening for breath sounds, and feeling for air movement on your cheek.

If the child is not breathing normally or is only gasping (agonal breathing), treat this as cardiac arrest.

When to Start CPR

• If you are alone, start CPR immediately and continue for one minute before going to get help.
• If someone else is present, they should call 999 straight away while you start CPR.

In children, cardiac arrest is often caused by a lack of oxygen, so early CPR can help restore breathing and circulation.

Five Initial Rescue Breaths

Begin CPR with five rescue breaths:

• Open the airway
• Pinch the nose closed
• Seal your mouth over the child’s mouth
• Breathe steadily for up to one second, just enough to see the chest rise
• Allow the chest to fall before giving the next breath

Repeat until five effective breaths have been delivered.

Chest Compressions

• Place the heel of one hand in the centre of the chest, on the lower half of the sternum, between the nipples
• Keep your arms straight and shoulders directly above your hand
• Compress the chest to one-third of its depth (approximately 4–5 cm in a small child)
• Compress at a rate of 100–120 per minute
• Allow the chest to fully recoil between compressions

If the child is larger or you cannot achieve enough depth, use two hands, one on top of the other.

After the initial five breaths, continue CPR using a ratio of 15 compressions to 2 rescue breaths, keeping interruptions to a minimum.

If two rescuers are present, swap roles every two minutes to prevent fatigue and maintain effective compressions.

Using an AED on a Child

As soon as an AED becomes available:

• Switch it on immediately and follow the voice prompts
• Use paediatric pads if available
• Place one pad on the chest and one on the back between the shoulder blades
• For children under 25 kg (around 8 years old), position the front pad slightly to the left side of the chest
• If only adult pads are available, use them, ensuring they do not touch

The AED will analyse the heart rhythm and advise whether a shock is needed.

• When instructed, ensure everyone is standing clear
• Make sure no one is touching the child
• Deliver the shock if advised

Immediately resume CPR after the shock, continuing with 15 compressions and 2 breaths until the AED re-analyses or help arrives.

Continue CPR Until

• The child starts breathing normally or shows signs of life, such as movement or eye opening
• Emergency services arrive and take over
• You are physically unable to continue

Key Points to Remember

• Always check for safety first
• Call 999 early — if alone, after one minute of CPR
• Give five initial rescue breaths before compressions
• Continue 15 compressions to 2 breaths at 100–120 per minute
• Use an AED as soon as it is available
• Swap rescuers every two minutes where possible to maintain CPR quality

Early CPR and early defibrillation save lives. Acting quickly and confidently gives a child the best possible chance of survival.