Adult vs. Child CPR: Understanding the Critical Differences
Last Updated: February 12, 2026
CPR technique changes based on the age of the person you are helping. The AHA defines three age categories: infant (under 1 year), child (1 year to puberty), and adult (puberty and older). Each category has specific compression depth, technique, and ratio requirements.
Getting these differences right matters because children and infants are not just small adults. Most pediatric cardiac arrests start as breathing problems, not heart rhythm disorders, which fundamentally changes the approach.
Practice age-appropriate CPR techniques in our AHA classes.
Key Differences at a Glance
| Factor | Adult | Child (1 to puberty) | Infant (under 1 year) |
|---|---|---|---|
| Compression depth | 2 to 2.4 inches | ~2 inches (1/3 chest) | ~1.5 inches (1/3 chest) |
| Compression method | 2 hands, heel of hand | 1 or 2 hands, heel of hand | Two-thumb encircling or 1 hand |
| Rate | 100-120/min | 100-120/min | 100-120/min |
| Single rescuer ratio | 30:2 | 30:2 | 30:2 |
| Two rescuer ratio | 30:2 | 15:2 | 15:2 |
| Rescue breaths | Recommended if trained | Essential (breathing cause) | Essential (breathing cause) |
| AED pads | Adult pads | Pediatric pads if available | Pediatric pads; front/back if pads may touch |
Why Children Need Rescue Breaths More Than Adults
The most important clinical difference is the cause of arrest. Most adult cardiac arrests are caused by a heart rhythm problem (ventricular fibrillation), which means the blood still contains oxygen. This is why hands-only CPR can be effective for adults during the first few minutes.
Most pediatric cardiac arrests are caused by breathing failure, meaning the child's oxygen levels are already depleted when the heart stops. Without rescue breaths, compressions alone circulate blood that carries very little oxygen.
A Japanese pediatric study demonstrated this clearly: conventional CPR with rescue breaths produced 25.9% favorable neurological survival in children, compared to only 9.3% for compression-only CPR.
This is why the AHA emphasizes conventional CPR (compressions plus breaths) for all pediatric patients rather than hands-only approaches.
The 2025 Technique Changes
The most significant change affecting pediatric CPR is the elimination of the two-finger infant compression technique, replaced by the two-thumb encircling hands method.
For children, the 2025 guidelines added back blows to the choking protocol for the first time: 5 back blows alternating with 5 abdominal thrusts, mirroring the new adult protocol.
Compression rate (100 to 120 per minute) and the basic sequence remain the same across all age groups.
Complete guide to the new infant CPR technique.
AED Use Across Age Groups
For adults, use standard adult AED pads. For children under 8 years or under 55 pounds, use pediatric pads or a pediatric dose attenuator if available. If pediatric equipment is not available, adult pads may be used on a child. For infants, pediatric pads are preferred. If the pads might touch each other on the infant's small chest, place one pad on the front and one on the back.
The 2025 guidelines recommend immediate AED use for all ages, including infants. Do not delay AED application while performing CPR.
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