How Do You Perform CPR on a Child or Infant in Australia?

Performing CPR on a child or infant in Australia follows the same basic principles as adult CPR, but with important differences in technique. For children aged 1 to puberty, you can use one or two hands on the chest, while for infants under 1 year, you use two fingers or the encircling thumbs technique. Compressions should be about one-third of the chest depth for both children and infants, which is shallower than adult CPR.

According to the Australian Resuscitation Council (ARC), early and effective CPR significantly increases survival for a child or infant experiencing cardiac arrest. If you witness a collapse, immediately call Triple Zero (000), begin CPR, and use an AED if available.

Key Differences Between Child and Infant CPR

The age-based distinctions that affect CPR technique in Australia:

• Infant (under 1 year): Two-finger technique or encircling thumbs; mouth-to-mouth-and-nose rescue breaths; compression depth approximately 4 cm
• Child (1 year to puberty): One-hand or two-hand technique; mouth-to-mouth rescue breaths; compression depth approximately 5 cm

The compression-to-ventilation ratio is 30:2 for single rescuers. With two rescuers available, the ratio changes to 15:2.

Step-by-Step CPR for a Child (1 Year to Puberty)

Step 1: Check for Responsiveness

Gently tap the child’s shoulder and call out loudly. If the child does not respond, is not breathing normally, or is only gasping, begin CPR immediately. Check for breathing for no more than 10 seconds.

Step 2: Call for Help

Call Triple Zero (000) or ask someone nearby to call. If an AED is available, send someone to retrieve it.

Step 3: Open the Airway

Place the child on their back on a firm, flat surface. Tilt the head back gently by placing one hand on the forehead and lifting the chin with the other hand.

Step 4: Give 5 Initial Rescue Breaths

The ARC recommends 5 initial rescue breaths before chest compressions for a child. Pinch the nose shut, create a complete seal over the mouth, and blow steadily for about 1 second per breath. Watch for the chest to rise.

Step 5: Begin Chest Compressions

Place the heel of one hand on the centre of the chest over the lower half of the breastbone. Use one hand for smaller children or two hands for larger children. Compress to a depth of approximately 5 cm at a rate of 100 to 120 compressions per minute.

Step 6: Continue the Cycle

Perform 30 compressions followed by 2 rescue breaths. Continue without interruption until emergency services arrive, the child breathes normally, or you are too exhausted to continue.

Step-by-Step CPR for an Infant (Under 1 Year)

Step 1: Check for Responsiveness

Flick the sole of the infant’s foot or tap the shoulder gently. An unresponsive infant who is not breathing or is only gasping requires immediate CPR.

Step 2: Call for Help

Call Triple Zero (000) immediately. If another person is present, have them call while you begin CPR.

Step 3: Open the Airway

Place the infant on their back on a firm surface. Tilt the head back slightly into a neutral position — do not over-extend the neck. Lift the chin gently with one finger.

Step 4: Give 5 Initial Rescue Breaths

Cover both the infant’s mouth and nose with your mouth. Give 5 gentle breaths, each lasting about 1 second, using just enough air to make the chest visibly rise.

Step 5: Begin Chest Compressions

Two-finger technique (single rescuer): Place two fingers on the centre of the chest just below the nipple line. Compress to approximately 4 cm depth at 100 to 120 compressions per minute.

Encircling thumbs technique (two rescuers): Place both thumbs on the centre of the chest while fingers encircle the torso to support the back. This is preferred when two rescuers are available.

Step 6: Continue the Cycle

Perform 30 compressions followed by 2 rescue breaths (or 15:2 with two rescuers). Continue until emergency services arrive or the infant recovers.

Using an AED on a Child or Infant

If an AED becomes available, use it as soon as possible. Most AEDs in Australia have paediatric pads or a paediatric mode. For infants and children under 8 years or under 25 kg, use paediatric pads if available. Place one pad on the centre of the chest and one on the centre of the back for infants. Ensure no one is touching the child when the AED analyses or delivers a shock. If paediatric pads are not available, adult pads on a child are acceptable.

Common Mistakes to Avoid

• Compressing too gently: Effective CPR requires firm compressions to about one-third chest depth. Shallow compressions do not circulate blood adequately.
• Interrupting compressions: Minimise pauses. Even brief interruptions reduce blood flow to the brain.
• Over-ventilating: Too forceful breaths can cause gastric inflation rather than lung inflation, especially in infants.
• Waiting too long to act: Every minute without CPR reduces survival by approximately 10%.
• Incorrect hand placement: Compressions should be on the lower half of the breastbone, not the stomach or too high on the chest.

Training and Certification

While this guide covers the fundamentals, formal CPR training is strongly recommended. A hands-on course teaches correct technique, depth, and rhythm through practice on manikins. ALIT offers first aid courses that include CPR training:

• HLTAID009 Provide CPR — focused CPR training, 3.5 hours, $75
• HLTAID011 Provide First Aid — comprehensive first aid including CPR, $160

HLTAID009 covers both adult and child/infant CPR techniques. HLTAID011 includes CPR as part of a broader first aid skill set. Both are delivered from our West Melbourne campus on a weekly basis. Current guidelines recommend CPR refresher training at least every 12 months.

Frequently Asked Questions

At what age does child CPR change to adult CPR?

The transition occurs at puberty. The ARC uses puberty as the dividing line because physical maturity affects compression depth and hand placement.

Can I perform CPR if I am not trained?

Yes. Australian Good Samaritan laws provide legal protection for anyone who attempts to help in an emergency, as long as they act in good faith. Doing something is always better than doing nothing.

How hard should I press during infant CPR?

Compress to approximately one-third of chest depth (about 4 cm). Focus on maintaining a consistent rhythm and allowing the chest to fully recoil between compressions.

Should I remove an infant’s clothing before CPR?

Remove thick or bulky clothing so you can place your fingers correctly. However, do not waste time — begin CPR immediately and adjust as needed.