CPR for Kids and Adults: What Actually Changes by Age

What Is the Same for Every Age?

Start here, because it is the part most parents get wrong in the other direction — they assume child CPR is a completely different skill and freeze rather than try. It is not. Four things hold constant from a newborn to a ninety-year-old:

• The rate. 100 to 120 compressions per minute. Every age. This never changes.
• The ratio. 30 compressions to 2 breaths for a single rescuer. (Two trained rescuers working on a child or infant switch to 15:2.)
• The location. The center of the chest, on the lower half of the breastbone.
• The recoil. You let the chest come all the way back up between compressions. Leaning on the chest between pushes is one of the most common errors at every age, and it stops the heart from refilling.

So if you have ever taken an adult CPR class, you already know the rhythm. What you are adjusting is force and hand position — and, in a drowning, the order you do things in.

What Changes Between Kids and Adults?

Three things, and they are all about scale. An adult chest is a thick, resistant structure that needs two stacked hands and the weight of your upper body. An infant chest is small enough that two fingertips can compress it a third of the way down. A child sits between the two.

That last row surprises people, so it is worth explaining. An adult who collapses is most often having a cardiac event, and the single thing that will restart that heart is a defibrillator — so getting help moving is the priority. A child in cardiac arrest is usually there because they stopped breathing first: drowning, choking, an asthma attack. Oxygen is the treatment, and you are the one holding it. That is why the sequence flips.

If you want the child-specific technique in full detail, our CPR basics for pool parents walks through compressions and rescue breaths for children and infants step by step.

Why Is Drowning CPR Different from Regular CPR?

This is the single most important thing on this page, and it applies to kids and adults equally.

Standard bystander CPR training for adults now emphasizes hands-only compressions — no breaths, just push. That guidance exists because most adult cardiac arrests are electrical problems, and the blood in the body is still carrying oxygen for the first few minutes. Compressions alone move it.

Drowning is the opposite problem. The heart stopped because oxygen ran out. There is no reservoir of oxygenated blood to circulate. Compressing an empty tank does not help. Both the American Heart Association and the American Red Cross therefore carve out drowning as an exception: give 2 rescue breaths first, then begin compressions, and keep breaths in the cycle throughout.

Hands-only CPR is a reasonable fallback for an untrained bystander at a shopping mall. It is the wrong protocol at a pool. If you remember one thing from this article, remember that — and see our poolside CPR quick card, which you can print and keep in the pool bag.

What Does a Real Poolside Scene Look Like?

Guidance is easy to read and hard to act on, so here is the sequence as it actually unfolds when a child is pulled from the water unresponsive.

1. Get them out and flat. On a firm surface — the pool deck, not a lounger. Do not waste time trying to drain water from the lungs; there is no water to drain, and attempts to do so delay the things that work.
2. Check, out loud. Tap the shoulder, shout the child's name. Look at the chest for no more than 10 seconds. Occasional gasping — agonal breathing — is not breathing.
3. Point at a specific person. “You, in the red shirt, call 911 and come back and tell me you did it.” Named instructions get followed; “somebody call 911” does not.
4. 2 rescue breaths. Head tilt, chin lift, watch for the chest to rise. If it does not rise, reposition the head and try once more.
5. 30 compressions. Hands sized to the child, one-third of chest depth, 100–120 per minute, full recoil.
6. Keep the cycle going. 30 and 2, until they breathe on their own, an AED arrives, or paramedics take over. Swap with another adult every two minutes if you can — compression quality falls off fast and most rescuers do not notice it happening.

Two things that get missed in the adrenaline: the surface matters (a soft mattress or a float absorbs the compression instead of the chest), and you should say the count out loud. Counting aloud keeps your rate honest and tells everyone else on the deck exactly where you are.

The rescue itself — getting the child out safely without becoming a second victim — is a separate skill. Our guide to parent CPR and water rescue basics covers reach-throw-don't-go and AED use on a child.

What Happens After They Start Breathing?

Every drowning victim who required any rescue breathing goes to a hospital. Every one. Even if they sit up, cough, and say they feel fine.

The reason is that water in the lungs continues to irritate the tissue and interfere with oxygen exchange for hours after the incident. The American Academy of Pediatrics is unambiguous that a child pulled from the water who needed resuscitation, or who had any episode of unconsciousness, needs medical evaluation — and parents should watch for persistent coughing, laboured or rapid breathing, unusual sleepiness, vomiting, or a change in behaviour in the hours afterward.

If the person is breathing and unresponsive, roll them onto their side into the recovery position so that fluid drains rather than pools. Stay with them. Keep them warm — hypothermia is common after any water incident and makes everything harder to manage.

And then, when the day is over: a child who nearly drowned is a child who will be frightened of the water. That fear is treatable, and rebuilding comfort matters. Helping a child who is afraid of the water covers how to do it without forcing.

Where Should You Actually Learn This?

Reading an article is not the same as training. What reading gives you is the shape of the thing — enough to recognise what is happening and not freeze. What a class gives you is muscle memory in your hands, and the experience of finding out that proper compression depth takes more force than you expect.

The two national providers are the American Red Cross and the American Heart Association. Both offer courses that include child and infant CPR alongside adult, which is what a parent wants; an adult-only workplace course will leave out exactly the part you need. Expect two to four hours and a certification good for two years. Many YMCAs, hospitals, fire departments and parks departments run them at low or no cost.

We have written a full guide to finding and choosing a CPR class for kids — what the certification levels mean, what online-only courses do and do not qualify you for, and how to tell whether a class actually includes infant manikins.

One more thing worth saying plainly: CPR is the backup plan, not the plan. It is what you reach for after every layer of prevention has already failed. Fencing, supervision, life jackets and swim lessons are what keep you from ever needing this page. Our five layers of protection explains how they stack — and if the swim-lesson layer is the one you are missing, our free directory of swim programs covers all fifty states.

Authoritative Sources

• Centers for Disease Control and Prevention — Drowning Facts
• American Red Cross — CPR Training and Certification
• American Heart Association — CPR & ECC Guidelines
• American Academy of Pediatrics — Water Safety and Young Children
• National Drowning Prevention Alliance

Frequently Asked Questions

Is CPR the same for kids and adults?

The rhythm is the same — 100 to 120 compressions per minute at a 30:2 compression-to-breath ratio for a single rescuer. Three things change: hand placement (two fingers for infants, one or two hands for children, two hands for adults), compression depth (about 1.5 inches for infants, 2 inches for children, at least 2 inches for adults), and the amount of force. The biggest practical difference for parents is that a child's chest needs about one-third of its depth compressed, not the full adult force.

At what age do you switch from child CPR to adult CPR?

The American Heart Association uses puberty as the dividing line, not a birthday. If the person shows visible signs of puberty — chest development in girls, underarm hair in boys — use adult CPR. Below that, use child CPR from age 1 up. Infant CPR applies under age 1. If you are unsure and the person looks like a teenager, use adult technique; the risk of under-compressing is greater than the risk of over-compressing.

Do you start CPR with breaths or compressions?

It depends on the cause. For a cardiac arrest in an adult — the classic clutch-the-chest collapse — you start with compressions, because there is still oxygenated blood in the body that needs moving. For a drowning victim of any age, you start with 2 rescue breaths, because the heart stopped as a consequence of oxygen loss. The American Heart Association and the American Red Cross both make this drowning exception explicit.

How many compressions per minute for a child versus an adult?

The same: 100 to 120 compressions per minute, for infants, children and adults alike. This is one of the few CPR numbers that does not change with age. A useful pacing cue is any song around 110 beats per minute; most CPR instructors teach at least one.

Can you hurt a child by doing CPR wrong?

You can crack a rib — this happens in adult CPR routinely and is considered an acceptable trade. But a child in cardiac arrest is already, clinically, not alive. The American Red Cross is direct about this: imperfect CPR performed immediately is enormously better than perfect CPR that arrives four minutes later, and far better than no CPR at all. Hesitation costs more lives than technique errors do.