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 study, analyzing data from more than 10,000 children in the U.S. Cardiac Arrest Registry to Enhance Survival (CARES), found that the time window for successful CPR in children may be half that of adults—5 minutes versus 10 minutes.
“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 at 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 study examined how delays in starting CPR affect survival and brain function in children under 18 who experience out-of-hospital cardiac arrest. For children who received lay rescuer CPR, compared to those who did not, the analysis found that survival odds increased by 91% when CPR was started within one minute, 98% when initiated in two to three minutes, and 37% when performed in four to five minutes. However, survival odds decreased by 24% when CPR was initiated in six to seven minutes, 33% in eight to nine minutes, and 41% when started after 10 minutes or more. A similar pattern emerged for favorable brain function at discharge.
“We were not surprised that CPR initiated within five minutes 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 underscore the urgent need to increase the number of lay rescuers trained in CPR, particularly for children. “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 added. “This is especially tricky for children after cardiac arrest because lay rescuers may feel like they may hurt the child by doing CPR.”
Dianne Atkins, M.D., FAHA, FAAP, volunteer past-chair of the American Heart Association Emergency Cardiovascular Care Committee, commented: “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.”
The study’s findings align with 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 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.
The preliminary study reviewed data from the Cardiac Arrest Registry to Enhance Survival (CARES), a U.S. registry that now includes data on more than 175 million people. 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 five minutes.
One limitation is that the time to CPR administration was calculated based on when someone called 911, relying on EMS reports that may not always be exact. Future research could focus on shortening time to CPR through improved dispatcher instructions or broader CPR training in schools and during well-child visits, according to Jawad.
The abstract is considered preliminary until published in a peer-reviewed scientific journal.
