The American Heart Association pediatric CPR guidelines for 2025 provide detailed direction for infants and children. Pediatric resuscitation follows the same general structure as adult CPR, but there is one critical difference. Many pediatric arrests begin with breathing failure, not sudden cardiac rhythm collapse. Because of that, early rescue breaths and oxygen support play a larger role in pediatric CPR. The 2025 guidance keeps compressions central while reinforcing ventilation quality and correct age based technique.
This summary explains the current pediatric CPR steps for 2025, including infants and children, ratios, depth targets, and AED use.
Pediatric age groups
The AHA separates pediatric CPR into two main groups.
Infant
Under 1 year of age.
Child
From 1 year to puberty.
Age matters because chest size and hand positioning change, and the risks of over compression or over ventilation are higher in smaller bodies.
Recognize pediatric cardiac arrest
Begin CPR if a child or infant is unresponsive and not breathing normally. Gasping is abnormal breathing. Trained providers may check a pulse, but keep it brief. If there is no definite pulse, or the pulse is too slow to support life, begin CPR.
The pediatric CPR sequence in 2025
The sequence is similar to adults, with one timing note for solo rescuers.
- Ensure the scene is safe.
- Check responsiveness and breathing.
- Shout for help.
- If you are alone and the arrest was not witnessed, provide about 2 minutes of CPR before leaving to call for help and get an AED. If the collapse was witnessed, call immediately, then start CPR.
- Begin compressions and breaths.
- Apply an AED as soon as it is available.
The purpose of the 2 minute CPR window for unwitnessed arrest is to deliver oxygen and circulation early, since breathing failure is often the trigger.
Child CPR guidelines for 2025
Child CPR uses compressions and breaths together.
Compression rate
100 to 120 per minute.
Compression depth
About one third of the chest depth. For most children, this is around 2 inches.
Hand placement
Compress on the center of the chest on the lower half of the sternum. Use one hand or two hands based on the size of the child. The goal is to reach correct depth without using excess force.
Recoil and pauses
Allow full recoil after each compression. Keep interruptions short. Switch rescuers when available to limit fatigue and preserve depth.
Breaths and ratios
Provide breaths early and consistently.
Single rescuer ratio is 30 compressions to 2 breaths.
Two rescuer ratio is 15 compressions to 2 breaths.
Each breath should last about 1 second and create visible chest rise. Avoid forceful breaths. Too much air can cause gastric inflation and reduce effective ventilation.
Infant CPR guidelines for 2025
Infant CPR uses the same rhythm priorities but with different technique.
Compression rate
100 to 120 per minute.
Compression depth
About one third of chest depth, which is around 1.5 inches for most infants.
Compression technique
For one rescuer, use two fingers in the center of the chest just below the nipple line.
For two rescuers, use the two thumb encircling hands technique. This approach supports better depth control and more consistent recoil.
Breaths and ratios
Infants need gentle ventilations early.
The single rescuer ratio is 30 to 2.
The two rescuer ratio is 15 to 2.
Cover the infant’s mouth and nose with your mouth to create a seal. Deliver small breaths only until you see a slight chest rise.
AED use for infants and children
AED use is recommended for pediatric cardiac arrest when available.
Use pediatric pads or a pediatric dose attenuator when possible.
If only adult pads are available, they can be used. Place one pad on the front of the chest and one pad on the back, so the pads do not touch.
Turn the AED on, place pads, follow prompts, clear the patient during analysis and shock delivery, then resume CPR immediately.
Choking and airway emergencies
Airway obstruction is a common pediatric crisis. If a choking child or infant becomes unresponsive, begin CPR. Before ventilation, look in the mouth for a visible object. Remove it only if you can see it clearly. Do not sweep blindly, since this can push the object deeper.
Common pediatric CPR mistakes to avoid
The AHA continues to call out errors that reduce CPR quality in kids.
- Compressions that are too shallow
- Using too much force on infants
- Delaying rescue breaths
- Incorrect ratios for two rescuer CPR
- Long pauses between compressions
- Waiting too long to apply the AED
- Ventilating too hard or too fast
Small technique errors can matter more in infants and children, so steady practice is important.
Key takeaways for 2025 pediatric CPR
The 2025 pediatric guidelines reinforce core principles while highlighting the importance of early, effective ventilation. For both infants and children, begin CPR quickly when arrest is detected. Deliver compressions at 100 to 120 per minute and about one third chest depth. Provide breaths early, and use the correct ratio based on how many rescuers are present. Apply an AED as soon as it is available, using pediatric pads if you have them. Regular training helps keep these skills precise and aligned with current AHA standards.