4.2 Infant/Child Chest Compressions

The universal rate for chest compressions in all cardiac arrest victims (adult, child, and infant) is 100 to 120 per minute. Similarly, the compression-to-ventilation ratio for a single rescuer is 30:2 across all age groups. For two-rescuer CPR, the compression-to-ventilation ratio for infants and children changes to 15:2, while adults remain at 30:2.

Chest Compression Technique

For most children, chest compressions are performed using two hands

, just like in adult CPR. However, for very small children, compressions can be performed with one hand as long as the depth reaches at least 1/3 of the chest diameter (approximately 2 inches or 5 cm).

Guidelines for High-Quality Chest Compressions

• Perform compressions at a rate of 100 to 120 compressions per minute.
• Compress the chest at least 1/3 of the chest diameter (about 2 inches or 5 cm for children).
• Allow the chest to fully recoil after each compression.
• Minimize interruptions in chest compressions.

Important: Do not move the victim unless they are face down, in immediate danger, or lying on a soft or unstable surface (e.g., a bed or bathtub).

Child Chest Compressions

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Child Chest Compressions

1. Ensure the child is lying face up on a firm, flat surface. If you need to move or roll them, do so with caution—especially if a head or neck injury is suspected.
2. Position yourself correctly: Stand or kneel at the child’s side.
3. Hand Placement and Body Positioning:
   • Place the heel of one hand in the center of the child’s chest on the lower half of the sternum.
   • Position your second hand on top, interlocking fingers.
   • For smaller children, use one hand only and keep fingers off the ribs.
   • Straighten your arms and position your shoulders directly over your hands for max force.
4. Begin Chest Compressions:
   • Compress at 100–120 per minute (try to match the rhythm of “Staying Alive”).
   • Push hard and fast—at least 1/3 of chest diameter (~2 inches or 5 cm).
   • Allow the chest to fully recoil between compressions.

Infant Chest Compressions

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Infant Chest Compressions

1. Ensure the infant is lying face up on a firm, flat surface. Move only if necessary.
2. Hand Placement:
   • Place two fingers in the center of the infant’s chest, just below the nipple line (avoid the tip of the breastbone).
3. Begin Chest Compressions:
   • Rate: 100–120 compressions per minute.
   • Depth: 1/3 of chest diameter (~1.5 inches or 4 cm).
   • Ensure full chest recoil after each compression.
4. Rescue Breaths:
   • After every 30 compressions, open the airway with a head tilt–chin lift.
   • Give 2 breaths, each lasting 1 second, with visible chest rise.
5. After 5 cycles (~2 minutes):
   • Activate the Emergency Response System (ERS) and retrieve an AED.
   • Continue CPR until EMS arrives or the child shows signs of life.