Quick Bystander CPR Within Five Minutes Nearly Doubles Pediatric Cardiac Arrest Survival
New research shows that initiating CPR within five minutes of a child's cardiac arrest can nearly double survival rates, highlighting the critical importance of immediate bystander intervention for pediatric emergencies.
Cardiopulmonary resuscitation performed within five minutes of a child's cardiac arrest nearly doubled their chances of survival, according to preliminary research to be presented at the American Heart Association's Resuscitation Science Symposium 2025. The study analyzed data from more than 10,000 children in the Cardiac Arrest Registry to Enhance Survival (CARES), a U.S. registry that tracks out-of-hospital cardiac arrests and now includes data on more than 175 million people.
The findings reveal that the time window for successful CPR initiation in children may be half that of adults - 5 minutes versus 10 minutes, respectively. "If a child's heart suddenly stops, every second counts. Starting CPR immediately can nearly double their chances of survival," said lead study author Mohammad Abdel Jawad, M.D., M.S., a research fellow of the University of Missouri-Kansas City and Saint Luke's Mid America Heart Institute in Kansas City.
Among the 10,991 children who had an out-of-hospital cardiac arrest, about half received bystander CPR. The analysis showed dramatic differences in survival based on when CPR was initiated. The odds of survival increased 91% when a lay rescuer started CPR within one minute after cardiac arrest, 98% when initiated in two to three minutes, and 37% when performed in four to five minutes. However, survival odds decreased 24% when CPR began in six to seven minutes, 33% when performed in eight to nine minutes, and 41% when started 10 minutes or more after cardiac arrest.
"We were not surprised that CPR initiated within five minutes of cardiac arrest improved survival odds in children," Jawad said. "However, we were struck by how quickly the benefit dropped off after five minutes. In adults, a recent study reported survival benefits even when CPR was started at nine minutes; however, our analysis confirms that in children the time window was much shorter."
The research also found a similar pattern between the time to lay rescuer CPR and favorable brain survival, with better outcomes observed when CPR was initiated within 5 minutes of cardiac arrest. Overall, more than 15% of the children survived to hospital discharge, and nearly 13% had favorable brain function at discharge.
These findings underscore the urgent need to increase CPR training among potential lay rescuers, including parents, family members, teachers, coaches and community members. "These findings highlight the urgent need to teach and encourage more people to learn CPR and feel confident using it right away," Jawad emphasized. "This is especially tricky for children after cardiac arrest because lay rescuers may feel like they may hurt the child by doing CPR."
The research supports the American Heart Association's Nation of Lifesavers movement, which aims to double cardiac arrest survival rates by 2030. According to American Heart Association data, 9 out of every 10 people who experience cardiac arrest outside of a hospital die, in part because they do not receive immediate CPR more than half of the time. The complete research abstract can be found in the American Heart Association's Scientific Sessions/Resuscitation Science Symposium 2025 Online Program Planner.
Future research could focus on how to shorten time to CPR even more, such as improved dispatcher instructions or broader implementation of CPR training in schools and during well-child visits. The study was selected as a finalist for the Max Harry Weil Early Career Award presented at the American Heart Association Resuscitation Science Symposium 2025.