Quick Bystander CPR Within Five Minutes Nearly Doubles Pediatric Cardiac Arrest Survival

Cardiopulmonary resuscitation performed within five minutes of a child's heart stopping 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 for more than 10,000 children from the Cardiac Arrest Registry to Enhance Survival (CARES), a U.S. registry that tracks out-of-hospital cardiac arrests and includes data on more than 175 million people.

The research found the time window for successful CPR initiation in children may be half that of adults - 5 minutes versus 10 minutes, respectively. Among the 10,991 children who had an out-of-hospital cardiac arrest, about half received bystander CPR, with the median time to receive lay rescuer CPR being three minutes. Overall, more than 15% of the children survived to hospital discharge, and nearly 13% had favorable brain function at discharge.

"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. "We found the time window is even more critical in children, so it is imperative to emphasize starting CPR as soon as possible after a cardiac arrest."

The analysis revealed dramatic differences in survival odds based on when CPR was initiated. For children who received lay rescuer CPR compared to those who did not, the odds of survival increased 91% when started 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 findings highlight the urgent need to increase CPR training among potential lay rescuers, including parents, family members, teachers, coaches and community members. 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 organization's Nation of Lifesavers movement aims to double cardiac arrest survival rates by 2030.

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 authors note that while these findings are significant, they are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal. The complete research abstract is available through the American Heart Association's Scientific Sessions Online Program Planner.