Cardiopulmonary resuscitation (CPR) performed within five minutes of a child’s heart stopping nearly doubled their chances of survival, according to preliminary research to be presented at the American Heart Association’s Resuscitation Science Symposium 2025. The meeting will be held Nov. 8-9 in New Orleans and will feature the latest advances in the treatment of cardiovascular injuries and life trauma.
Cardiac arrest occurs when the heart’s electrical system suddenly malfunctions and stops pumping blood to the rest of the body, resulting in loss of blood to the brain, lungs, and other vital organs. CPR for children consists of cycles of 30 chest compressions, at 100-120 compressions per minute, followed by two breaths. For adults, CPR administered within 10 minutes of cardiac arrest is associated with better outcomes, however, the optimal time for CPR after cardiac arrest for children is unclear.
If a child’s heart stops suddenly, every second counts. Starting CPR right away can almost double their chances of survival. We found that timing is even more critical in children, so it is imperative to emphasize starting CPR as soon as possible after a cardiac arrest.”
Mohammad Abdel Jawad, MD, MS, lead author of the study, a researcher at the University of Missouri-Kansas City and Saint Luke’s Mid America Heart Institute, Kansas City
“These findings underscore the urgent need to teach and encourage more people—parents, family members, teachers, coaches, and community members—to learn CPR and feel confident using it immediately,” Jawad said. “This is especially difficult for children after cardiac arrest because lay rescuers may feel they may harm the child by performing CPR. We have found that timing is even more critical in children, so it is imperative to emphasize starting CPR as soon as possible when they are in cardiac arrest.”
The preliminary study looked at data on more than 10,000 children from a large US database that tracks out-of-hospital cardiac arrests. Researchers looked at how delays in starting CPR affect survival in children under 18 who have an out-of-hospital cardiac arrest. They also analyzed whether the timing of starting CPR by lay rescuers — such as family, friends or strangers before emergency services (EMS) arrived — affected brain function.
For children who received rescuer CPR, compared with those who did not, the analysis found:
- The chances of survival increased by 91% when a lay rescuer started CPR within one minute of cardiac arrest, 98% when it was started within two to three minutes, and 37% when it was performed within four to five minutes of cardiac arrest.
- However, the odds of survival dropped by 24% when a lay rescuer started CPR within six to seven minutes, 33% when it was performed within eight to nine minutes, and 41% when it was started 10 minutes or more after cardiac arrest.
- A similar pattern emerged between time to start rescue CPR and favorable brain survival.
“We were not surprised that CPR started within five minutes of cardiac arrest improved children’s chances of survival,” Jawad said. “However, we were struck by how quickly the benefit fell off after five minutes. In adults, a recent study reported survival benefits even when CPR was started at nine minutes. However, our analysis confirms that in children the time frame was much shorter. This highlights how critical every minute is after pediatric cardiac arrest.”
One of the study’s limitations is that the time to administer CPR, which the research team calculated based on the time someone called 911 dispatch, depended on EMS reports that may not always be accurate.
“Future research could focus on how to reduce CPR time even further, such as improved dispatcher instructions or broader implementation of CPR training in schools and during well-child visits to increase the number of rescuers available to administer CPR,” Jawad said.
Study details, history and results:
- The researchers looked at data from the Cardiac Arrest Registry to Enhance Survival, or CARES, a US registry that collects information on cardiac arrests that occur outside hospitals and now includes data on more than 175 million people, or more than half the US population.
- Among the 10,991 children who had an out-of-hospital cardiac arrest, about half (5,446) received bystander CPR.
- The median time to receive lifeguard CPR was three minutes.
- Overall, more than 15% (1,677) of the children survived after hospital discharge. and nearly 13% (1,420) had favorable brain function at discharge, with better outcomes seen when SPR was initiated within 5 minutes of cardiac arrest.
This research supports the fact that in a cardiac emergency, every second counts. Science shows that when lay rescuers step in and start CPR within the first few minutes, survival rates can more than double and the chances of preserving brain function increase dramatically. The time frame for children is shorter, but regardless of age, quick action is not only helpful, but can be life-saving.”
Dianne Atkins, MD, FAHA, FAAP, volunteer past chair of the American Heart Association Committee on Emergency Cardiovascular Care and pediatric cardiologist and professor, University of Iowa
Acting quickly after a cardiac emergency is one of the cornerstones of the American Heart Association’s Nation of Lifesavers™ movement, which aims to double survival rates from cardiac arrest by 2030. According to American Heart Association data, 9 out of 10 people who experience out-of-hospital cardiac arrest die, in part because they don’t receive CPR more than half the time. CPR, especially if performed immediately, can double or triple a person’s chances of survival.
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