Study: Bystander CPR with rescue breaths leads to better outcomes in pediatric cardiac arrest.

A study out of the Children’s Hospital of Philadelphia, published in the Journal of the American College of Cardiology, supports the use of rescue breathing for children and infants in cardiac arrest.

Public health efforts to encourage the public to perform CPR by teaching a hands-only style of CPR have led to a situation where most laypersons are trained in compression-only CPR. This was due in part to a belief that the public was resistant to performing mouth-to-mouth rescue breathing for victims, and therefore wouldn’t perform CPR at all. That may work for adults, but children are not simply small adults. Children and infants usually suffer from a respiratory problem that leads to cardiac arrest.

This has led to an assumption that hands-only CPR is just as effective for pediatrics as it is for adults. This study shows that there is a great need for education of the public in the benefits of CPR with rescue breathing for children and infants. The study also shows that CPR with rescue breathing is the only type of CPR for infants that results in good neurological outcomes.

CPR statistics from the pediatric bystander CPR study

Compression-only CPR on infants had a similar outcome as infants who did not receive any bystander CPR. Children who received CPR with rescue breathing were 1.5 times as likely to have better neurological outcomes than those who received compression-only CPR.

While those public health efforts to teach hands-only CPR have benefited witnessed cardiac events in adults, it is very likely those efforts have disadvantaged children.

Update: the science won. The American Heart Association’s 2025 Guidelines put renewed emphasis on compressions with rescue breaths, especially for children, drowning victims, and overdose victims. If you have children in your life, learn how to give proper rescue breaths and how to perform CPR on a child, and consider our free online CPR training that covers adult, child and infant CPR.

Compression-only versus Rescue-breathing Bystander CPR in Pediatric Out-of-Hospital Cardiac Arrest. Journal of the American College of Cardiology, 2021

In my 33 years of service as a firefighter, there was one thing that pained me to hear. When the family member said “I just didn’t know what to do”. If people only knew how simple it really is to save lives. That’s when I started teaching in 1991. As an American Heart Association Instructor for the last 32 years, I have trained over 170,000 people in the art of saving lives. I also realized I can only train so many people with in person classes. This online CPR course changes all that.