Research Highlights:
- Initiating CPR within the first five minutes after cardiac arrest can nearly double the chances of survival for children, according to preliminary research analyzing data for more than 10,000 children from a U.S. registry of out-of-hospital cardiac arrests.
- The time window to initiate successful CPR in children may be half that of the window for adults — 5 minutes vs. 10 minutes, respectively.
- The study's findings highlight the importance of bystanders (lay rescuers) initiating CPR quickly after cardiac arrest, particularly for children, and the need to continue increasing the number of people with the knowledge and skills to administer CPR.
- Note: The study featured in this news release is a research abstract. Abstracts presented at American Heart Association's scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as full manuscripts in a peer-reviewed scientific journal.
DALLAS, Nov. 3, 2025 — Cardiopulmonary resuscitation (CPR) 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 meeting will be held Nov. 8-9 in New Orleans and will feature the most recent advances related to treating cardiopulmonary arrest and life-threatening traumatic injury.
Cardiac arrest occurs when the heart's electrical system abruptly malfunctions and stops the heart from pumping blood to the rest of the body, which results in loss of blood to the brain, lungs and other vital organs. CPR for children consists of cycles of 30 chest compressions, at 100-120 compressions per minute, followed by two breaths. For adults, bystander CPR administered within 10 minutes after cardiac arrest is associated with better outcomes, however, the optimal time window for CPR after cardiac arrest for children is unclear.
"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. "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."
"These findings highlight the urgent need to teach and encourage more people — parents, family members, teachers, coaches and community members — to learn CPR and feel confident using it right away," Jawad said. "This is especially tricky for children after cardiac arrest because lay rescuers may feel like they may hurt the child by doing CPR. We found the time window is even more critical in children, so it is imperative to emphasize starting CPR as soon as possible when they are in cardiac arrest."
The preliminary study reviewed data for more than 10,000 children from a large U.S. database that tracks out-of-hospital cardiac arrests. Researchers examined how delays in starting CPR affect survival in children under age 18 who have a cardiac arrest outside the hospital. They also analyzed whether the timing of CPR initiation by lay rescuers — such as family, friends or strangers before emergency medical services (EMS) arrive — affected brain function.
For children who received lay rescuer CPR, compared to those who did not, the analysis found:
- The odds of survival increased 91% when a lay rescuer started CPR within one minute after the cardiac arrest, 98% when initiated in two to three minutes and 37% when performed in four to five minutes after cardiac arrest.
- However, the survival odds decreased 24% when a lay rescuer initiated CPR in six to seven minutes, 33% when performed in eight to nine minutes and 41% when started in 10 minutes or more after the cardiac arrest.
- A similar pattern emerged between the time to lay rescuer CPR and favorable brain survival.
"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. This highlights just how critical every minute is after pediatric cardiac arrest."
One of the study's limitations is that the time to CPR administration, which the research team calculated based on the time someone called 911 dispatch, depended on EMS reports that may not always be exact.
"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 to increase the number of lay rescuers available to administer CPR," Jawad said.
Study details, background and results:
- Researchers reviewed data from the Cardiac Arrest Registry to Enhance Survival, or CARES, a U.S. registry that collects information about cardiac arrests occurring outside of hospitals and now includes data on more than 175 million people, or more than half of the U.S. population.
- Among the 10,991 children who had an out-of-hospital cardiac arrest, about half (5,446) received bystander CPR.
- The median time to receive lay rescuer CPR was three minutes.
- Overall, more than 15% (1,677) of the children survived to hospital discharge; and nearly 13% (1,420) had favorable brain function at discharge, with better outcomes observed when lay rescuer CPR was initiated within 5 minutes of cardiac arrest.
"This research supports the fact that in a cardiac emergency, every second counts. Science shows that when lay rescuers step in and begin CPR within the first few minutes, survival rates can more than double, and the chances of preserving brain function dramatically increase. The time interval for children is shorter, but regardless of age, quick action isn't just helpful, it can be lifesaving," said Dianne Atkins, M.D., FAHA, FAAP, volunteer past-chair of the American Heart Association Emergency Cardiovascular Care Committee and a pediatric cardiologist and professor at the University of Iowa.
Acting quickly after a cardiac emergency is one of the cornerstones of the American Heart Association's Nation of Lifesavers™ movement, which has a goal of doubling 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. CPR, especially if performed immediately, can double or triple a person's chance of survival.
Co-authors, disclosures and funding sources are listed in the abstract.
Statements and conclusions of studies that are presented at the American Heart Association's scientific meetings are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association's scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.
