Most children receive no bystander cardiopulmonary resuscitation (CPR) during out-of-hospital cardiac arrest.¹ Compression-only CPR (COCPR) without rescue breathing is more readily performed than conventional CPR due to simplicity and lack of hygiene concerns, with resultant improvement in overall survival and neurologic prognosis in adult studies. The American Heart Association (AHA) exclusively recommends bystander COCPR in adults.² Pediatric cardiac arrest is most often of respiratory etiology, and it was unclear if COCPR was as effective in this population.