The Critical Role of Lay-Rescuer CPR in Pediatric Cardiac Arrest

Preliminary research presented at the American Heart Association's Resuscitation Science Symposium shows children who suffer out-of-hospital cardiac arrest have substantially higher survival when lay-rescuer CPR is started within five minutes, nearly doubling survival and making immediate bystander action the decisive early determinant of outcome.

An analysis of a U.S. registry of more than 10,000 children with out-of-hospital cardiac arrest found that lay-rescuer CPR begun within one to three minutes was associated with roughly 91% to 98% higher odds of survival. The reported benefit declined after five minutes; adult series typically identify a longer effective window closer to ten minutes. Earlier initiation of CPR correlated with higher rates of favorable neurologic and functional recovery at discharge, although registry-based timing estimates limit causal inference.

Evidence shows dispatcher instructions increase bystander CPR rates and shorten call-to-compression intervals, accelerating initiation in many pediatric arrests. Prioritizing clear, immediate dispatcher coaching and tracking call-to-compression times are practical, measurable steps that systems can adopt to narrow delays.