Which of the following are components of high-quality CPR for children? (Select 3 answers)

The answer

High-quality CPR for a child rests on the same core principles the American Heart Association applies across all ages, but with pediatric-specific numbers. The three components you should select are:

1. Adequate rate and depth. Compress the chest 100 to 120 times per minute. For a child, push down at least one-third of the depth of the chest (roughly 2 inches / 5 cm); for an infant it is about 1.5 inches / 4 cm. Too shallow fails to move blood; too fast prevents the heart from refilling.
2. Complete chest recoil. Let the chest fully return to its normal position after every compression without leaning on it. Recoil is what allows the heart to refill with blood before the next push.
3. Minimizing interruptions. Every pause in compressions lets blood pressure and coronary flow collapse. Aim to keep hands-off time as short as possible so the chest compression fraction stays high (ideally at least 60 percent of the resuscitation).

Why the other options are wrong

Typical distractors on this question include "compress as fast as possible," "push as deep as you can," "give breaths first," or "avoid chest recoil to build pressure." Each misstates the physiology:

• "As fast as possible" is wrong because rates above 120/min shorten the filling phase, so the heart pumps less blood per beat, not more.
• "As deep as you can" overshoots — excessive depth can injure the ribs, liver, or heart. The target is a controlled one-third of chest depth.
• "Avoid full recoil" or "lean on the chest" is the opposite of correct; leaning prevents refilling and directly lowers cardiac output.
• "Breaths before compressions" contradicts the C-A-B sequence (Compressions, Airway, Breathing) that AHA uses for most cardiac arrests.

The bigger picture

Chest compression fraction is the percentage of total arrest time during which compressions are actually being delivered. Keeping it high is why we minimize interruptions — pauses for pulse checks, breaths, or rhythm analysis should be brief.

Pediatric CPR differs from adult CPR in a few ways beyond depth: for a single rescuer the ratio is 30 compressions to 2 breaths, but for a child or infant with two rescuers it changes to 15:2. Compressions are often done with two fingers or two thumbs for infants and one or two hands for a child. Because pediatric arrest is more often caused by a respiratory problem than a sudden cardiac event, effective ventilation carries extra weight — but it never replaces the three compression fundamentals above.