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CPR in children (1 year until puberty)

What is CPR?

CPR stands for cardiopulmonary resuscitation. CPR is an emergency procedure that involves chest compressions (pushing hard down on the chest) and rescue breaths (mouth-to-mouth resuscitation). When given properly, CPR can help deliver oxygen to the brain and other organs until help arrives or until your child recovers. Causes of cardiac arrest in children and teens are usually a result of a major injury or illness and rarely from underlying heart disease.

This method applies to children between 1 year old and puberty. Once puberty has begun, children should receive CPR as adults.

Other causes may include:

  • drowning
  • suffocation
  • electrocution
  • poisoning or intoxication
  • life-threatening (anaphylactic) allergic reactions.

This information can refresh your memory if you have already undergone a CPR course. It does not replace real, hands-on CPR training. CPR courses are often available through local recreation programs, advanced swim programs, and first aid programs. In Canada, such programs are offered by the Canadian Red Cross, Heart and Stroke Foundation and St. John Ambulance for example. The basic skills are simple and usually only take a few hours to learn.

Giving CPR to your child

Check to see if your child is responsive by tapping them on the shoulder and asking loudly, “Are you OK?”. If your child does not answer, follow these instructions depending on your situation:

  • If you are not alone, have someone else call 911 and get an AED (automated external defibrillator) right away, if available, while you are doing CPR.
  • If you are alone and have a cell phone, start CPR while calling 911 from your cell phone on speaker. After two minutes of CPR (five cycles), go get an AED if available.
  • If you are alone and have no cell phone, start CPR for two minutes (five cycles) and then call 911 from a landline and get an AED if available.

Chest compressions: Push hard, push fast

Begin CPR by laying your child down on a firm, flat surface. Do not spend time trying to find a pulse. Place the heel of one or two hands over the lower third of your child's breastbone and give them 30 quick chest compressions (push fast). Be sure to push hard enough so their chest moves approximately 5 cm (2 inches) down (push hard).

Count out loud. You should deliver about 100-120 compressions a minute. Wait for the chest to come all the way back to its initial position between compressions. This will get the blood flowing to your child's brain and other vital organs.

Child standing by a pool  

Rescue breaths

Open the airway

After the first 30 chest compressions, place the palm of your hand on your child’s forehead. Place two fingers on the hard, bony tip of their chin and gently tilt their neck back. This will open your child's airway.

Child standing by a pool  

Two rescue breaths

Pinch your child's nose and place your mouth over their mouth and give two breaths. Each breath should be just enough to make your child’s chest rise and should be no more than one second in length. Make sure you see your child's chest rise with each breath.

Child standing by a pool  


Give cycles of 30 chest compressions and two breaths during two minutes and repeat until the ambulance arrives or your child starts breathing again. Two minutes usually allow for five cycles of 30 chest compressions and two breaths.

A two-minute CPR cycle is usually tiring. If you are not alone, switch who is giving CPR every two minutes.

Child standing by a pool  

Recovery position

Once your child has recovered and started breathing again on their own, put them in the recovery position​ until help arrives. The recovery position will help keep your child’s airway open and prevent them from chocking on their own vomit. If your child vomits, wipe it away. Make sure nothing is blocking or covering his mouth and nose.

Child standing by a pool  

 Key points

  • Take an official course to learn real, hands-on CPR.
  • CPR involves both chest compressions and rescue breathing (mouth-to-mouth resuscitation). Give 30 compressions and 2 rescue breaths; repeat this cycle until help arrives or your child recovers.
  • If your child is unresponsive and not breathing or only gasping despite stimulation, start CPR right away and have someone else call 911.
  • Once your child starts breathing, put them in the recovery position. This will keep their airway open.

 Emily Louca, BSc, RRT​​

​At SickKids:

The Hospital for Sick Children​ offers the Heart and S​troke Foundation’s First Aid program​. It provides CPR and resuscitation training for patients, families and the general public.​