CPR (Cardiopulmonary Resuscitation) Process in Adults, Children, and Infants: Definition, Steps & Uses
Introduction
Cardiopulmonary Resuscitation (CPR) is a life-saving technique used in emergencies when someone’s heartbeat or breathing has stopped. Whether due to cardiac arrest, drowning, or other causes, CPR can double or triple the chances of survival if performed immediately. This article explains the CPR process tailored for adults, children, and infants, including when and how to perform it, differences by age group, and the importance of early intervention.
What is CPR?
CPR (Cardiopulmonary Resuscitation) is a medical emergency procedure that combines chest compressions and artificial ventilation (rescue breaths) to maintain circulatory flow and oxygenation during cardiac arrest.
It has two main components:
• Chest compressions: To manually pump the heart and circulate blood.
• Rescue breaths: To supply oxygen to the lungs and bloodstream.
Importance of CPR
• Maintains blood flow to the brain and organs.
• Increases survival chances during cardiac arrest.
• Buys time until professional medical help arrives.
Early CPR, especially if combined with an AED (Automated External Defibrillator), is crucial to minimize brain damage and increase the likelihood of full recovery.
When is CPR Needed?
• CPR is required when a person is:
• Unconscious
• Not breathing or only gasping
• Showing no pulse
• Common scenarios include:
• Cardiac arrest
• Drowning
• Suffocation
• Chokin
• Electric shock
Severe allergic reactions (anaphylaxis)
General Guidelines Before Starting CPR
1. Check responsiveness – Tap the person and shout.
2. Call for help – Dial emergency services (e.g., 911 or 112).
3. Assess breathing and pulse – No pulse or abnormal breathing? Begin CPR.
4. Position the person – Lay them on their back on a firm, flat surface.
5. Start CPR immediately – Begin compressions within 10 seconds.
CPR in Adults (Age: Puberty and Older)
Step-by-Step CPR Process for Adults:
1. Ensure Safety
Make sure the environment is safe for both you and the victim.
2. Check Responsiveness
Tap their shoulders and ask loudly, “Are you okay?”
3. Call Emergency Services
If unresponsive, call for help or ask someone to call and get an AED.
4. Check Breathing and Pulse
Look for chest movement, listen for breathing, and feel for a pulse. If absent, start CPR.
CPR Procedure:
Compressions:
• Place the heel of one hand on the center of the chest (lower half of the sternum).
• Place the other hand on top, interlocking fingers.
• Keep elbows straight, shoulders over hands.
• Push down at least 2 inches (5 cm) deep.
• Maintain a rate of 100–120 compressions per minute.
• Allow full chest recoil after each compression.
Airway:
Tilt the head back and lift the chin to open the airway.
Breathing:
• Pinch the nose shut, cover their mouth with yours.
• Give 2 rescue breaths, watching for chest rise.
• Each breath should last about 1 second.
Continue cycles of 30 compressions. and 2 breaths until help arrives or the person begins to breathe.
Note: If you’re not trained in rescue breathing, Hands-Only CPR (continuous chest compressions) is recommended.
CPR in Children (Age: 1 Year to Puberty)
Children require a gentler technique compared to adults but still need immediate action. Causes of cardiac arrest in children often stem from respiratory failure or trauma.
Step-by-Step CPR Process for Children:
1. Check Responsiveness and Breathing
Gently shake and shout. Check for normal breathing and pulse.
2. Call for Help
If you’re alone, perform CPR for 2 minutes before calling emergency services.
CPR Procedure:
Compressions:
• Use one or two hands depending on the size of the child.
• Push down about 2 inches (5 cm) in the center of the chest.
• Perform 30 compressions at a rate of 100–120 per minute.
• Allow full recoil between compressions.
Airway and Breathing:
• Tilt the head back slightly less than in adults (avoid hyperextension).
• Give 2 gentle breaths, watching for chest rise.
• Continue 30:2 compression-to-breath cycles until help arrives or the child recovers.
CPR in Infants (Age: 0–12 Months)
Infants are extremely delicate, and CPR must be performed very gently. Common causes of cardiac arrest include SIDS (Sudden Infant Death Syndrome), choking, trauma, or infections.
Step-by-Step CPR Process for Infants:
1. Check Responsiveness
Tap the soles of the feet or gently flick the foot. No response? Begin CPR.
2. Call for Help
If alone, perform 2 minutes of CPR before calling emergency services.
CPR Procedure:
Compressions:
• Use two fingers (index and middle) placed just below the nipple line on the breastbone.
• Compress the chest about 1.5 inches (4 cm) deep.
• Maintain 100–120 compressions per minute.
Airway:
Tilt the head slightly to open the airway – just a slight tilt (neutral position).
Breathing:
• Seal your mouth over the infant’s nose and mouth.
• Give 2 small puffs (not full breaths).
• Watch for chest rise.
Continue 30 compressions and 2 breaths per cycle.
If two trained rescuers are available, use the two-thumb encircling hands technique and do 15 compressions to 2 breaths.
Key Differences in CPR: Adults vs Children vs Infants
Feature Adult Child Infant
• Age Group Puberty and older 1 year to puberty 0–12 months
• Compression Depth At least 2 inches (5 cm) About 2 inches (5 cm) About 1.5 inches (4 cm)
• Hand Placement Two hands on sternum One or two hands on sternum Two fingers (or thumbs)
• Rescue Breaths Mouth-to-mouth Mouth-to-mouth Mouth-to-mouth and nose
• CPR Ratio (1 rescuer) 30:2 30:2 30:2
• CPR Ratio (2 rescuers) 30:2 15:2 15:2
Hands-Only CPR
For untrained bystanders or those uncomfortable with mouth-to-mouth resuscitation, hands-only CPR is recommended for adults:
• Call for emergency help.
• Start chest compressions.
• No rescue breaths needed.
Hands-only CPR is not recommended for children and infants, as they usually need rescue breaths due to respiratory-related cardiac arrest.
• CPR with AED (Automated External Defibrillator)
• An AED can significantly increase survival rates.
Steps:
1. Turn on the AED.
2. Follow voice prompts.
3. Attach electrode pads.
4. Allow AED to analyze the heart rhythm.
5. Deliver a shock if advised.
6. Resume CPR immediately.
For Children/Infants: Use pediatric pads if available; if not, use adult pads but ensure they don’t touch each other.
Common Mistakes to Avoid During CPR
Inadequate depth or rate of compressions.
• Not allowing the chest to fully recoil.
• Incorrect hand placement.
• Too many interruptions.
• Not calling emergency services first.
CPR Training and Certification
Learning CPR through a certified course (e.g., by Red Cross, American Heart Association, or local medical bodies) ensures you’re prepared for real-life emergencies. Training often includes:
• Adult, child, and infant CPR.
• AED usage.
• Choking response.
• First aid basics.
Many online and in-person courses are available worldwide.
CPR FAQs
Q1. How long should CPR be performed?
Until the person recovers, emergency services arrive, or you’re too exhausted to continue.
Q2. Can you hurt someone by performing CPR?
There’s a risk of broken ribs, but CPR is vital and can save lives — any damage is treatable compared to death from inaction.
Q3. Is mouth-to-mouth always necessary?
Not for adults if you’re untrained. Hands-only CPR is sufficient for most adult cardiac arrests.
Q4. What if I’m not sure whether the person needs CPR?
If in doubt and the person is unresponsive and not breathing normally, start CPR. It’s better to act than to wait.
Conclusion
CPR is an essential emergency skill that can save lives across all age groups—adults, children, and infants. While the core principle remains the same, the technique and approach vary based on age. Being trained and confident in administering CPR could make you the difference between life and death in a critical moment.
If you haven’t yet, consider enrolling in a certified CPR course and stay updated with the latest guidelines. Every second counts in a cardiac emergency. Be ready. Be a lifesaver.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group)