November 12, 2025
2 min read
Key takeaways:
- Bystander CPR performed within the first 5 minutes of a cardiac arrest in children can nearly double their survival odds.
- The optimal time to initiate CPR may be half the recommended time window for adults.
NEW ORLEANS — A child who receives bystander CPR within the first 5 minutes after a cardiac arrest is nearly twice as likely to survive compared with children who receive CPR 5 to 10 minutes later, registry data show.
The findings were presented during the Resuscitation Science Symposium at the American Heart Association Scientific Sessions.
Data were derived from Jawad MH, et al. OR 115. Presented at: American Heart Association Scientific Sessions; Nov. 7-10, 2025; New Orleans.
“What we learned from a study using the Cardiac Arrest Registry to Enhance Survival registry is that when bystander CPR was initiated within the first 10 minutes in adults it was associated with better outcomes compared with those who did not receive bystander CPR,” Mohammad Abdel Jawad, MD, MS, a research fellow at the University of Missouri-Kansas City and St. Luke’s Mid America Heart Institute in Kansas City, Missouri, told Healio. “We cannot extrapolate this 10-minute range to pediatrics. Cardiac arrest in children is different. Most of the cardiac arrests in children occur in those younger than age 1, and the most common cause is usually respiratory rather than cardiac, which is not what we see in adults. Everyone knows that we must do early CPR, but how early? What is better?”
Mohammad Abdel Jawad
The researchers conducted a retrospective study using data from the Cardiac Arrest Registry to Enhance Survival (CARES) registry assessing 10,965 children who had an out-of-hospital cardiac arrest. Of those, 5,446 (49.5%) received bystander CPR. Nearly 90% of those cardiac arrests occurred at home, Jawad said. The primary outcome was survival to hospital discharge; the secondary outcome was favorable neurological survival.
Researchers found that the median time to bystander CPR was 3 minutes.
Overall, 15.3% of children survived to hospital discharge and 12.9% had favorable neurological survival.
Jawad said researchers observed a graded, inverse relationship between time to bystander CPR and survival to discharge when performed within the first 5 minutes, with an adjusted odds ratio of 1.91 when performed within the first minute after an arrest (95% CI, 1.65-2.2); an odds ratio of 1.98 when performed during the first 2 to 3 minutes (95% CI, 1.63-2.4); and an odds ratio of 1.37 when performed during the first 4 to 5 minutes (95% CI, 1.09-1.72). Researchers observed a similar relationship when assessing favorable neurological survival.
“When CPR was initiated within the first 3 minutes after the cardiac arrest, patients had more than twofold higher odds for survival,” Jawad told Healio. “We are talking about 27% compared with less than 10%. That 2- to 3-minute difference will increase your chance of survival by more than half. I do not think there is any intervention that will double the chance of survival rather than doing CPR just 2 minutes earlier.”
Jawad said the findings clearly show the need for more CPR education.
“We need more community initiatives, perhaps conducted during well-child visits,” Jawad told Healio. “This could be done with a simple QR code linking to a 2-minute video on how to perform CPR. Most parents spend about 10 minutes or more waiting for the provider. Why don’t we do something beneficial during that wait time that will improve outcomes?”
Sources/Disclosures
Source:
Jawad MH, et al. OR 115. Presented at: American Heart Association Scientific Sessions; Nov. 7-10, 2025; New Orleans.
Disclosures:
Jawad reports no relevant financial disclosures.
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