TempoLife › Features › Defibrillators and cardiac arrest response › children
A child or a baby
Paediatric arrest usually starts with breathing, not with the heart. Five breaths first, one hand or two fingers, a third of the chest depth — and what to do when the defibrillator only has adult pads.
CPR in sixty seconds
- Unresponsive and not breathing normally? Gasping is not breathing. Treat it as a cardiac arrest.
- Call 112 (113 in Norway). Speaker on, phone on the floor. Stay on the line — the dispatcher will coach you.
- Push hard and fast in the centre of the chest: 5–6 cm in an adult, 100–120 per minute, letting the chest come all the way back up.
- Send somebody else for a defibrillator. Do not go yourself unless it is seconds away. Keep compressing.
- Turn the device on and do what it says. It decides whether to shock. After a shock, go straight back to compressions.
This is a reference written for bystanders, not a diagnosis, a training course or medical advice. It cannot tell you what is wrong with a particular person, and it does not replace the dispatcher on the other end of an emergency call — they can see what is near you and they will talk you through it. If you are worried about your own heart, or about a symptom, that is a conversation with a clinician rather than a page on a website.
A different cause needs a different opening
Adults arrest because the heart's electrics fail. Children almost always arrest because breathing fails first — an obstructed airway, a severe asthma attack, drowning, infection, a seizure — and the heart stops afterwards from lack of oxygen. That single fact drives the whole paediatric sequence: give five rescue breaths before any compressions, then continue with thirty compressions to two breaths, or fifteen to two if two trained rescuers are present. Restoring oxygen is the treatment; the compressions circulate it.
Compressions on a small chest
Compress the lower half of the breastbone to about one third of the depth of the chest — roughly 5 cm in a child, roughly 4 cm in an infant under one year — at the same 100 to 120 a minute as an adult. For a child, use the heel of one hand, or two hands if the child is large or you are not strong enough with one. For a baby, use two fingertips if you are alone, or the two-thumbs encircling technique if there are two of you, which produces better pressures. Let the chest come all the way back up between compressions, exactly as in an adult.
Call, and when to call
If you are alone with a collapsed child and have a phone, put it on speaker and call 112 while you work. If you are alone with no phone at all, the paediatric guidance differs from the adult one: give about a minute of CPR first, then go for help, because oxygen delivered now matters more in a child than a defibrillator delivered later. If anyone else is present, they call immediately and you never leave the child.
The defibrillator, and the adult-pad problem
Shockable rhythms are less common in children but they do happen, and a defibrillator is used the same way. Many public units carry paediatric pads or a key or switch that reduces the energy, intended for children under about eight years or 25 kg — use them if they are in the bag. If only adult pads are available, use them. An adult-energy shock into a child is far better than no defibrillation. On a small chest, place one pad on the front of the chest and one on the back so the pads cannot touch each other.
Choking, which is the arrest you can prevent
A child who cannot cry, cough or breathe is choking, and this is the most likely path to a paediatric arrest in a home. Give up to five firm back blows between the shoulder blades with the child leaning forwards, then five abdominal thrusts in a child over one year, or five chest thrusts in a baby — never abdominal thrusts in an infant. Alternate, and call 112. If the child becomes unresponsive, lay them down, start with five rescue breaths and continue CPR, looking into the mouth each time you open the airway and removing only what you can plainly see.
| Adult | Child (1 year to puberty) | Infant (under 1) | |
|---|---|---|---|
| Start with | Compressions | 5 rescue breaths | 5 rescue breaths |
| Hands | Two hands | One or two hands | Two fingers, or two thumbs |
| Depth | 5–6 cm | About one third of chest depth (~5 cm) | About one third of chest depth (~4 cm) |
| Rate | 100–120/min | 100–120/min | 100–120/min |
| Ratio (trained) | 30:2 | 30:2, or 15:2 with two rescuers | 30:2, or 15:2 with two rescuers |
| Alone, no phone | Call first | CPR for 1 minute, then call | CPR for 1 minute, then call |
Sources: European Resuscitation Council Guidelines · Käypä hoito national guideline: Elvytys · checked 2026-09-08
Frequently asked questions
Do I really start with breaths in a child?
Yes. Paediatric arrest is usually caused by a breathing problem, so five rescue breaths come before compressions. Any rescuer unwilling to give breaths should still start compressions rather than do nothing.
The AED has no child pads — can I still use it?
Yes, and you should. Adult pads with an adult shock are recommended over withholding defibrillation. Put one pad on the chest and one on the back so they cannot touch each other.
How deep on a baby?
About one third of the depth of the chest, roughly four centimetres, using two fingertips or the two-thumbs technique. It feels alarmingly firm, and shallow compressions are the common error.
What to do, right now
Is this a cardiac arrest?
Two checks decide it: not responding, and not breathing normally. The noisy gasping that fools nearly everyone, why a brief seizure at the start is a cardiac sign, and why a heart attack is a different emergency.
Hands-only CPR, in sixty seconds
Centre of the chest, 100 to 120 pushes a minute, 5 to 6 cm deep, let the chest come all the way back up, and do not stop. The rate, the depth, the fatigue problem, and a pacer that keeps you on the beat.
The emergency call, and the address problem
What the dispatcher asks, why the phone goes on speaker on the floor, how dispatcher-guided CPR works, and the single hardest question in a rural arrest: where exactly are you?
Using a defibrillator, step by step
Open it, turn it on, bare the chest, follow the voice. What the machine decides for you, what it will never do, and the one instruction people get wrong — go straight back to compressions after the shock.
Where the pads go, and what gets in the way
Right collarbone and left ribs, or front and back. Chest hair, sweat, snow, a medicine patch, a pacemaker lump, an underwired bra, a tattoo: which of these actually matter and what to do about each.
Everything on this subject
Before the emergency, there is a long quiet stretch
Blood pressure, resting heart rate, movement and sleep are the part of this you can act on for years beforehand. TempoLife keeps them in one place, free to start.