Using CPR and an AED on Children Ages 1 to 8

When a child has a medical emergency, knowing what to do next can save their life. If they stop breathing or collapse, you may need to do cardiopulmonary resuscitation (CPR) or use an automated external defibrillator (AED). This guide will walk you through the steps for using these lifesaving tools.

What is CPR?

Cardiopulmonary resuscitation (CPR) is used when a person isn’t breathing or is gasping for breath and their heart has stopped. CPR starts with chest compressions. It’s followed by rescue breathing. The chest compressions and rescue breathing are done in cycles. CPR helps keep oxygenated blood flowing through the body and into the lungs until breathing and a heartbeat can be restored.

The information below gives you the basics of CPR. The best way to learn CPR is in a training class. Contact the American Heart Association (800-242-8721, heart.org) or American Red Cross (800-733-2767, redcross.org) for classes in your area.

What is an AED?

An automated external defibrillator (AED) is a medical device. It checks the heart rhythm of a person who has collapsed or is unconscious. If needed, the AED gives an electric shock to get the heart beating again. AEDs are found in many public places. These include daycare centers, schools, offices, airports, fitness centers, and shopping malls. An AED used with CPR can save a person’s life.

How to do CPR and use an AED

Make sure the scene is safe.

Step 1. Check the child and call for help

  • Shout to get the child’s attention, using the child’s name. If the child does not respond, tap the child’s shoulder and shout again. Check the child for no more than 10 seconds.

  • If the child responds, stay with them. Call 911. Keep the child comfortable and warm until emergency rescuers arrive.

  • If the child does not respond, is not breathing, or is gasping, do the following:

    • If someone is with you, have them call 911 right away. They should also try to find an AED. In the meantime, begin chest compressions and rescue breathing (steps 2 and 3) right away.

    • If you’re alone, and did not witness the child collapse, first start chest compressions and rescue breathing (steps 2 and 3). Continue for 2 minutes. Then call 911 and check to see if an AED is immediately available.

      • If no AED is available, resume chest compressions and rescue breathing.

      • If an AED is available, use it, and follow the instructions for resuming chest compressions and rescue breathing.

      • If another helper arrives, have them assist by calling 911 and/or obtaining an AED, if not already done.

    • If you're alone and saw the child collapse, call 911 right away and use an AED if it is readily available. (See Step 4 below.) Follow the instructions of the AED to do chest compressions and rescue breathing. If no AED is readily available, start chest compressions and rescue breathing immediately after calling 911. If another helper arrives, have them assist by calling 911 and obtaining an AED, if not already done.

Step 2. Do chest compressions

  • Lay the child on their back on a firm, flat surface in a safe area.

  • Stand or kneel beside the child.

  • Place the heel of your hand in the center of their chest.

    • For a smaller child, use only 1 hand.

    • For a larger child, use 2 hands. Place your other hand on top and interlace your fingers. Lift your fingers so that just the heel of your hand is doing the work.

  • For a chest compression: Position your shoulders directly over your hand(s) and lock your elbow(s). Keep your arm(s) straight. Press down about 2 inches. You may hear and feel popping and snapping. Bones and cartilage will move during compressions.

  • Let the chest come back up fully after each compression. This lets the heart refill with blood. But keep your hands in place on the chest.

  • Give 30 compressions. Push down hard and fast at a rate of 100 to 120 per minute.

  • If you’re trained in CPR and can do rescue breaths, now is the time to do them (see step 3).

  • If you don't know how to give rescue breaths, keep doing compressions until the child shows obvious signs of life, an AED is available (see step 4), emergency rescuers or other help takes over, or you are unable to continue due to safety or fatigue.

Step 3. Start rescue breathing

  • Put 1 hand on the child’s forehead. With your other hand, put 2 fingers under the child’s chin and tilt the head upward. This keeps the airway open. Don’t tilt the head too far back.

  • Take a normal breath (not a deep breath). Pinch the child’s nose shut. Place your mouth over the child’s open mouth.

  • Give 1 slow breath. The breath should last 1 second (in your mind, count “one one-thousand”).

  • Check to see if the child’s chest rises.

    • If the chest rises, air has gone into the lungs. Let the child exhale.

    • If the chest does not rise, air has not entered the child’s lungs. The airway may be blocked. Remove your mouth from the child’s mouth, and tilt the child’s head again. Check if there is something in the child’s mouth. If you see an object in the mouth, sweep the mouth with your finger (don’t do this if you don’t see an object). Then give 1 more rescue breath. If the child’s chest still does not rise, give chest compressions again.

  • If you are alone, continue with a cycle of 30 compressions and 2 rescue breaths. Check for signs of life every 2 minutes.
  • If you are doing 2-person CPR, continue a cycle of 15 compressions and 2 rescue breaths. Check for signs of life every 2 minutes. Switch roles from compressions to rescue breathing every 2 minutes to help prevent fatigue.
  • Continue CPR until you see obvious signs of life, an AED or help arrives, or you are unable to continue due to safety or fatigue.
Step 4. Using the AED

  • Make sure you are in a dry area. If not, move the child to a dry area with a firm surface.

  • Remove the child’s clothing from their upper body. If needed, dry the child’s chest.

  • Turn on the AED. The device will speak instructions to you. Listen to and follow the instructions:

    • Put the pads on the child’s chest. Use small pads, meant for children. If small pads aren’t available, use the adult pads. If using adult pads, make sure the pads don’t touch each other. Follow the pictures on the instructions that come with the AED.

    • Follow the AED's instructions to not touch the child when it is checking the child’s heart rhythm.

    • The AED will deliver a shock if needed. Some AEDs will tell you to press a button to deliver the shock.

    • Don’t touch the child while the AED delivers a shock.

  • Start chest compressions and rescue breathing again (steps 2 and 3). Don't remove the chest pads even if the child wakes up. The pads cannot be reused once they are removed. Keep them on in case another emergency arises. The AED will continue to check the child’s heart rhythm.

  • If the child responds and starts breathing, stay with them. Keep them comfortable and warm until help arrives.

  • If the child does not respond, continue CPR with the instructions from the AED. Do this until you see obvious signs of life, or help arrives, or you are unable to continue due to safety or fatigue.