New Research Shows Five-Minute Window Critical for Child CPR Survival

Children who receive cardiopulmonary resuscitation from bystanders within five minutes of cardiac arrest have nearly double the chances of survival, according to preliminary research analyzing data from more than 10,000 pediatric cases. The study, to be presented at the American Heart Association's Resuscitation Science Symposium 2025, found the optimal time window for initiating CPR in children is significantly shorter than for adults - five minutes versus ten minutes respectively.

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, emphasized the urgency: "If a child's heart suddenly stops, every second counts. Starting CPR immediately can nearly double their chances of survival." The research team analyzed data from the Cardiac Arrest Registry to Enhance Survival (CARES), a U.S. registry that tracks out-of-hospital cardiac arrests and includes data on more than 175 million people.

Among the 10,991 children who experienced out-of-hospital cardiac arrest, approximately half received bystander CPR. The analysis revealed striking patterns: when lay rescuers initiated CPR within one minute after cardiac arrest, survival odds increased by 91%. This benefit remained strong at 98% when CPR began within two to three minutes and 37% when performed within four to five minutes. However, survival odds decreased by 24% when CPR started in six to seven minutes, 33% in eight to nine minutes, and 41% when initiated ten minutes or more after cardiac arrest.

The study also found a similar pattern between the timing of lay rescuer CPR and favorable brain survival outcomes. Overall, more than 15% of the children survived to hospital discharge, with nearly 13% maintaining favorable brain function at discharge. Better outcomes were consistently observed when lay rescuer CPR was initiated within the critical five-minute window. "We were struck by how quickly the benefit dropped off after five minutes," Jawad noted. "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 importance of increasing the number of people trained in CPR, particularly those who regularly interact with 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 emphasized. The research supports 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, nine out of every ten people who experience cardiac arrest outside of a hospital die, partly because they do not receive immediate CPR more than half of the time.

Future research could focus on strategies to shorten time to CPR administration, such as improved dispatcher instructions or broader implementation of CPR training in schools and during well-child visits. The complete study abstract is available through the American Heart Association's Scientific Sessions/Resuscitation Science Symposium 2025 Online Program Planner. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.