Cardiopulmonary resuscitation (CPR) is a vital life-saving skill that can be acquired through training and practice. While it's commonly associated with adults, teaching CPR to children and adolescents is gaining recognition as an essential aspect of preparedness and safety. The question arises: at what age should CPR training begin?
The AHA says CPR training can start at 9 years old (and sometimes younger)
Research and guidelines from the American Heart Association (AHA) state that CPR training can be introduced to children as young as nine years old. Some studies suggest that even earlier ages may be appropriate if the child has the physical ability to perform CPR.
Why age 9?
Although there isn’t a minimum age requirement to learn CPR, two of the primary considerations in determining the appropriate age for CPR training are cognitive and physical development. Children need to possess the cognitive ability to understand and follow CPR instructions, as well as the physical strength to perform chest compressions effectively. Around the age of nine, many children begin to develop these capabilities, making it an ideal time to introduce basic CPR training.
What do we know about CPR training for kids younger than 9?
A study published in the American Heart Association Journal examined the feasibility of teaching CPR to children as young as four years old. The study concluded that, from as early as 4, children can assess the first links in the chain of survival. By age 10 to 12, kids can consistently perform effective chest compression depths and ventilation volumes (mouth-to-mouth resuscitation) on training CPR manikins. By age 9 (and sometimes as young as age 6), children begin to develop the skills to do CPR correctly. This is why it is recommended to start CPR training at age 9 and repeat regularly (ideally annually).
Another factor to consider is the motivation and willingness of children to learn CPR. External research – and my own experience – indicate that children as young as 6 can express interest in learning CPR, particularly when they understand its potential to save the lives of their family members or peers. When my three-year-old son sees a CPR manikin bag, he asks to play CPR. He even knows to look for the feedback lights as he compresses the chest. My daughter, who is seven, can perform chest compressions on an adult manikin and can follow the directions of the AED.
Two weeks ago, I was invited to my son’s preschool to talk about safety. We discussed calling 911, listened to heartbeats with stethoscopes, and learned the basics of CPR. Attempting to keep things simple, I explained CPR as "pushing on the chest of a very sick person who was not breathing." The students observed me performing CPR on an infant manikin; they were then able to perform the skill and did not want to stop. I strongly believe this thirty-minute session will have a lasting impact on the students.
Integrating CPR into school curricula
Integrating CPR education into school curricula has shown promising results in reaching children at a younger age. Programs such as "CPR in Schools" aim to teach CPR skills to students as part of their regular education, starting as early as elementary school. By incorporating CPR training into the educational framework, children not only learn life-saving skills, but also normalize the concept of being prepared for emergencies from a young age.
While there is no definitive age at which CPR training must begin, experts emphasize the importance of starting early and gradually building upon skills as children grow and mature. Parents, educators, and healthcare providers play crucial roles in facilitating CPR education and ensuring that training methods are age-appropriate and engaging.
My experience teaching CPR to middle schoolers – and my own kids!
To date, I have taught over 160 students between the ages of 10 and 13 in grades 5 through 8 CPR and First Aid. Due to their school schedules, most of the CPR classes were conducted over two or four days, either during school or in an after-school program. To my initial surprise, the students did an amazing job learning. They quickly absorbed the information, were eager to ask questions, and demonstrated proper chest compressions and AED use. Most importantly, they were extremely proud to have learned a lifesaving skill and earned an official AHA CPR card that they could show off to their friends and family. In fact, these classes had a major, life-altering impact for one at least one of my students. Stay tuned to an upcoming blog about his story.
In conclusion, CPR training can be introduced to children as young as nine years old, with some studies suggesting potential feasibility at even younger ages. However, the key is to tailor training methods to suit the cognitive and physical development of each child, while also fostering motivation and interest in life-saving skills. By starting CPR education early and integrating it into school curricula, we can empower the next generation to be prepared to respond confidently and effectively in emergency situations.
References:
1. Cave, D. M., Aufderheide, T. P., Beeson, J., et al. (2010). Importance and Implementation of Training in Cardiopulmonary Resuscitation and Automated External Defibrillation in Schools. Circulation, 123(6), 691–706.
2. Lukas, R. P., Van Aken, H., Möllhoff, T., et al. (2012). Kids save lives: A six-year longitudinal study of schoolchildren learning cardiopulmonary resuscitation: Who should do the teaching and will the effects last? Resuscitation, 83(5), 619–625. https://www.sciencedirect.com/science/article/pii/S0300957216000666
3. Bollig, G., Myklebust, A.G. & Østringen, K. Effects of first aid training in the kindergarten - a pilot study. Scand J Trauma Resusc Emerg Med 19, 13 (2011). https://doi.org/10.1186/1757-7241-19-13
4. Saving lives with CPR? That's kid stuff, experts say, Michael Merschel, American Heart Association News https://www.heart.org/en/news/2024/02/13/saving-lives-with-cpr-thats-kid-stuff-experts-say
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