How should chest compressions be performed on a small child from 1 year old to puberty?

Performing chest compressions on a small child aged 1 year to puberty requires specific techniques to ensure effectiveness and safety. The recommended method involves using either one hand or two hands on the lower part of the sternum, which is the bone in the center of the chest. This approach is suitable because it allows for sufficient force to be applied while minimizing the risk of injury to the child's more fragile ribcage and thoracic structures.

When compressing at this location, it's crucial to apply firm, rapid compressions at a depth of about 1.5 to 2 inches, at a rate of 100 to 120 compressions per minute, which aligns with the guidelines for effective cardiopulmonary resuscitation (CPR) for children. This balance of depth and rate can help to ensure that blood circulates effectively in a child experiencing cardiac arrest or severe respiratory distress.

The use of both hands is generally recommended for larger children or adolescents, while one hand may suffice for smaller children, but both hands should not be excessively used as it could lead to injury. Techniques involving only one finger or compressions to the upper sternum, on the other hand, do not provide the necessary depths or pressures recommended for effective CPR in this age