For a very small child, what hand placement modification is allowed during CPR?

• A. One hand may be used
• B. Two hands must be used
• C. Two thumbs encircling chest
• D. Two fingers in center

Answer: (A)

In pediatric CPR, you adjust hand placement to fit the child's size so you can deliver effective chest compressions without overdoing it. For a very small child, using one hand is acceptable and often the best option. One hand allows you to control depth and maintain good chest recoil while still delivering the needed force—aiming for about one third the chest’s depth (roughly 2 inches or 5 cm for a child) at a rate of 100–120 compressions per minute. If the child is larger and the chest can accommodate it, two hands may be used, but the smaller size makes one hand a practical modification. Techniques like two-thumb encircling or two fingers are specific to infants and not the preferred approach here.