3.2 Child CPR and AED Decisions
Key Takeaways
- For a child, use one or two hands for compressions depending on size and rescuer ability.
- Compression depth is about one third of chest depth, commonly about 2 inches for a child.
- Use pediatric AED pads or settings when available, but early defibrillation remains important for shockable rhythms.
- Two rescuers should coordinate compression, ventilation, AED setup, and emergency activation.
3.2 Child CPR and AED Decisions
Child CPR questions often focus on adapting adult skills to smaller anatomy. Candidates must choose correct compression technique, maintain depth and rate, and use AED equipment without unnecessary delay.
Current official baseline
The adult BLS guidance covers recognition of cardiac arrest, emergency response activation, high-quality CPR, AED use, adult foreign-body airway obstruction, and opioid antagonist integration. Use the official AHA 2025 Adult Basic Life Support Guidelines page when your course materials or training-center instructions differ from third-party summaries: AHA 2025 Adult Basic Life Support Guidelines.
What you need to know
| Decision point | What to do |
|---|---|
| Hand position | Place hands on the lower half of the sternum. Use one hand for a small child or two hands if needed to reach correct depth. |
| Depth and rate | Use the same 100 to 120 per minute rate, but depth is based on one third of chest depth rather than adult inches alone. |
| AED priority | Attach pediatric pads if available. If not, follow course guidance rather than withholding a shock from a child in VF/pVT. |
| Team flow | One rescuer can compress while the other manages ventilations, AED, and role communication. |
How this shows up on BLS/ACLS questions
BLS and ACLS items usually test priority. Read the patient state first: age, pulse status, breathing status, rhythm, stability, and number of rescuers. Then choose the action that protects perfusion, oxygenation, defibrillation timing, or the correct algorithm branch. If an answer sounds advanced but delays CPR, shock delivery, ventilation, or an urgent stability intervention, it is usually a distractor.
Scenario anchor
A 7-year-old collapses during sports and the AED arrives with only adult pads. Do not delay defibrillation for a shockable rhythm while someone searches the building for pediatric pads.
Common traps
- Using infant two-thumb technique on a child.
- Delaying AED use because the patient is not an adult.
- Compressing too shallowly because of fear of injury.
Study action
Write this section as a one-line rule in your own words, then test it with mixed questions from the BLS/ACLS practice bank. Do not review only the matching topic. Mix it with nearby branches so you can tell when the rule applies and when it does not. For example, compare respiratory arrest with a pulse against pulseless arrest, or compare unstable tachycardia against VF/pVT arrest. The exam rewards that discrimination more than memorizing isolated facts.
A 3-year-old child is in cardiac arrest after choking on a toy. The child is found pulseless and not breathing. What FIRST action should be taken BEFORE initiating chest compressions?
The MOST common cause of cardiac arrest in infants and children (unlike adults) is: