How is responding to a child suffering cardiac arrest different to an adult?

While cardiac arrest is thankfully rare in children, it does happen, and knowing the differences when responding to a child in cardiac arrest compared to an adult can be the difference between life and death.

12 young people die each week in the UK as a result of Sudden Cardiac Arrest (SCA) and each year, sadly 270 children die from SCA at school.

Recognising cardiac arrest in young people

As Sudden Cardiac Arrest is relatively rare in young people, it is vital to recognise the signs and act swiftly if a cardiac arrest is suspected.

Newspapers reported in November 2024 that a 17-year-old Wycombe Wanderers football player Adam Ankers tragically died after his cardiac arrest was mistaken for a seizure, and Cardiopulmonary Resuscitation (CPR) was not started for 30 minutes.

Sudden Cardiac Arrest can often cause a response known as agonal breathing, this is an unconscious reflex when the body isn’t receiving enough oxygen and can sound like laboured breathing or gasping.

If Adam’s agonal breathing had been recognised as not normal breathing by bystanders or 999 call handlers then he may have received life support sooner and had a better outcome.

The signs of cardiac arrest in a young person or child are almost identical to that in an adult: they will immediately fall unconscious and be unresponsive, with no breathing or agonal breathing.

How is performing CPR on a child different?

The first line of treatment for someone who is unresponsive and not breathing normally should be to commence CPR. Due to a child having a smaller frame and smaller internal organs, the way CPR is performed on a child varies from how it is performed on an adult.

As with an adult, 999 should be called immediately if a cardiac arrest is suspected. Guidance states that five rescue breaths should be given before beginning chest compressions on a child.

Chest compressions should be performed differently on a child: compressions should be less deep on a child, pressing down by around 3-4 cm rather than 5 cm for adults. This lessens the risk of injuries such as broken ribs or damage to internal organs.

For infants under one year of age, two or three fingers should be used for compressions rather than the heel of the hand.

Using an AED on a child

An Automated External Defibrillator is the only definitive treatment for a cardiac arrest, delivering a shock that intends to restart an effective rhythm in the heart.

Some AEDs feature a built-in paediatric function, which delivers a shock with reduced energy suitable for a child aged 1 to 8 years old or under 55kg. For AEDs that don’t have a paediatric function, there are paediatric pads which are recognised by the device and reduce the shock accordingly.

Pad placement for a child is slightly different than on an adult: instead of both pads being placed on the chest, one is placed in the centre of the chest (anterior) while one is placed in the centre of the back (posterior).

Know how to respond with confidence in an emergency

Having the confidence to act decisively in a cardiac emergency can mean the difference between life and death. Taking part in a Paediatric First Aid course or a course on AEDs and CPR can build confidence and base knowledge in these situations.

Imperative Training has been providing fully accredited courses to businesses and individuals across the UK for more than two decades. Get in touch at sales@imperativetraining or visit our website to learn how we can support you.