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BMJ. 2007 Jun 9;334(7605):1201. Epub 2007 Apr 27.

At what age can schoolchildren provide effective chest compressions? An observational study from the Heartstart UK schools training programme.

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  • 1Prehospital Emergency Research Unit, Welsh Ambulance Services NHS Trust/Cardiff University, Wales School of Medicine, Cardiff CF11 8PL.



To determine at what age children can perform effective chest compressions for cardiopulmonary resuscitation.


Observational study.


Four schools in Cardiff.


157 children aged 9-14 years in three school year groups (ages 9-10, 11-12, and 13-14).


Participants were taught basic life support skills in one lesson lasting 20 minutes.


Effectiveness of chest compression during three minutes' continuous chest compression on a manikin.


No year 5 pupil (age 9-10) was able to compress the manikin's chest to the depth recommended in guidelines (38-51 mm). 19% of pupils in year 7 (age 11-12) and 45% in year 9 (age 13-14) achieved adequate compression depth. Only the 13-14 year olds performed chest compression as well as adults in other reported studies. Compression depth showed a significant relation with children's age, weight, and height (P<0.001). Multivariate analyses showed that, if the age and weight of the children were both known, the height (which is closely related to both) was no longer significant (P=0.95). No association was found between pupils' age, sex, weight, or height and the average rate of chest compressions over the three minute period. Similarly, no relation was found between year group and ability to place the hands in the correct position. During the three minutes' compression, compression rate increased and depth decreased.


The children's ability to achieve an adequate depth of chest compression depended on their age and weight. The ability to provide the correct rate and to employ the correct hand position was similar across all the age ranges tested. Young children who are not yet physically able to compress the chest can learn the principles of chest compression as well as older children.

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