TL;DR
CPR (cardiopulmonary resuscitation) is performed by recognizing cardiac arrest, calling 911 to activate EMS, starting hard and fast chest compressions, providing rescue breaths, and using an AED as soon as one is available. Hands-only CPR is effective for most adult cardiac arrests if you do not have a mask or if you’re uncomfortable. Immediate CPR and defibrillation within 3-5 minutes will give the best chance of survival.
What is Cardiac Arrest?
Cardiac arrest is when the heart stops pumping blood effectively. This can be a pulseless rhythm such as ventricular fibrillation, where the heart contracts but no blood is pumped, or when the heart stops completely. A person in cardiac arrest is clinically dead.
What Is CPR?
CPR (CardioPulmonary Resuscitation), is an emergency lifesaving technique used when a person is suffering cardiac arrest.
Performing CPR includes a combination of chest compressions and artificial respirations that provide oxygenated blood to the heart and major organs during cardiac arrest. Without CPR or advanced cardiac care, a person in cardiac arrest has no chance of survial. Death will occur within minutes. The purpose of CPR is to buy time until advanced life-saving care can be provided.
In most cases, CPR does not restart the heart of someone in cardiac arrest. The exception being someone suffering cardiac arrest due to respiratory arrest, like a drowning or choking victim.
What is an AED?
AED stands for Automated External Defibrillator. It’s an emergency medical device used to provide an electric shock to stop ventricular fibrillation. It will not restart the heart, but it will allow the heart to resume beating if possible.
Using an AED is simple. Public access defibrillation programs have made them readily available. AEDs have significantly increased the survival rate of sudden cardiac arrest outside of a hospital.
How to Perform CPR
When sudden cardiac arrest strikes, every second counts. Immediate CPR and defibrillation within 3-5 minutes will give the best chance of survival. Follow these steps to help save a life:
Step 1: Make Sure the Scene Is Safe
Don’t put yourself in danger. Before you provide aid, make sure both you and the victim are safe. If possible, move the victim out of danger before performing CPR.
Things to look for:
- Traffic
- Fire or smoke
- Electrical hazards
- Other dangerous situations
Step 2: Check for Responsiveness
Tap the shoulders (or feet for an infant), gently shake the victim and shout:
“Are you okay?”
If the person doesn’t respond:
- Check for breathing, at least once every 5-10 seconds.
- If not breathing: Look, listen, and feel for signs of circulation.
- If the person is not breathing normally, assume cardiac arrest.
Step 3: Call 911 and Get an AED
If someone else is nearby:
- Tell one person to call 911.
- Tell another person to get the nearest AED.
- Begin CPR immediately.
When you’re alone with an adult victim or a child victim and you witnessed the collapse:
- Call 911 first (or use your phone’s speaker mode).
- Get the AED if close by.
- Begin CPR.
If you’re alone with a child or infant victim and did not witness the collapse:
- Begin CPR immediately
- Perform 5 cycles (2 minutes) of CPR before calling 911 and getting the AED
Step 4: Begin Chest Compressions
Chest compressions are performed along with rescue breaths at a ratio of 30:2
Chest Compressions for Adults
Hand Placement for Adults
- Find the bottom rib and trace it to the center of the chest, this is the sternum.
- Place the heel of one hand on the center of the chest, about an inch above the sternum.
- Put your other hand on top.
- Interlock your fingers.
- Keep your elbows straight.
- Position your shoulders directly over your hands.
Compression Depth for Adults
- 2 – 2.5 inches
Compression Rate for Adults
- Push at a rate of: 100–120 compressions per minute
- Provide 30 compressions per cycle
A helpful rhythm is the beat of songs such as:
- “Stayin’ Alive” by the Bee Gees
- “Crazy in Love” by Beyoncé
Chest Compressions for Children (1 year to puberty)
Hand Placement for Children
- Find the bottom rib and trace it to the center of the chest, this is the sternum.
- Place the heel of one hand on the center of the chest, about an inch above the sternum.
- Keep your elbow straight.
- Position your shoulder directly over your hand
Compression Depth for Children
- 2 inches
Compression Rate for Children
- Push at a rate of: 100–120 compressions per minute
- Provide 30 compressions per cycle
Chest Compressions for Infants (less than 1 year old)
Hand Placement for Infants
- Find the bottom rib and trace it to the center of the chest, this is the sternum.
- Place 2 fingers on the center of the chest, just above the sternum.
Compression Depth for Infants
- 1.5 inches
Compression Rate for Infants
- Push at a rate of: 100–120 compressions per minute
- Provide 30 compressions per cycle
Allow the chest to fully recoil after every compression.
Step 5: Give Rescue Breaths
After providing 30 chest compressions, open the victim’s airway and provide 2 rescue breaths.
Open the Victim’s Airway
If you do not suspect spinal or cervical injury:
- Open the airway with a head tilt/chin lift
If you do suspect spinal or cervical injury:
- Open the airway with a jaw-thrust maneuver
Provide 2 Rescue Breaths
Rescue breaths on an adult or child:
- Pinch the victim’s nose and cover the mouth with your mouth (or use a barrier device).
- Breathe into the victim’s mouth, or compress the bag if using a bag-valve mask.
- Use enough force and volume to make the chest rise, allow the chest to return between breaths.
Rescue breaths on an infant:
- Cover the mouth and nose of the victim with your mouth (or use a barrier device).
- Breathe into the victim’s nose and mouth, or compress the bag if using a bag-valve mask.
- Use enough force and volume to make the chest rise, allow the chest to return between breaths.
Step 6: Use an AED as Soon as It Arrives
An AED (Automated External Defibrillator) can analyze the heart’s rhythm and, if appropriate, deliver a shock to help restore a normal heartbeat.
Using an AED is simple:
- Turn it on.
- Follow the voice prompts.
- Attach the pads as shown in the diagrams.
- Make sure no one is touching the person during analysis.
- Deliver a shock if instructed.
- Resume CPR when prompted by the AED.
AEDs are designed to be used by ordinary bystanders and provide clear, step-by-step instructions.
How Is Hands-Only CPR Performed?
Hands-only CPR is recommended as an alternative if you do not have a mask or barrier device, or if you do not feel safe providing ventilations.
Simply:
- Call 911 and activate EMS.
- Push hard and fast in the center of the chest, at a rate of 100-120 compressions per minute.
- Continue without stopping until EMS arrives or an AED is ready.
Hands-only CPR has saved thousands of lives because it encourages more bystanders to act quickly.
When Should You Stop CPR?
Continue CPR until one of the following:
- EMS arrives and takes over.
- Breathing and circulation return.
- You become physically unable to continue.
- The scene becomes unsafe.
Common CPR Mistakes to Avoid
Even well-intentioned rescuers sometimes make mistakes. Avoid these common errors:
- Waiting too long before starting CPR.
- Not pushing hard enough.
- Rescue breaths provided with too much force or volume
- Giving compressions too slowly.
- Stopping compressions for too long.
- Leaning on the chest between compressions.
Do You Need Certification to Perform CPR?
Absolutely not! Anyone can perform CPR during an emergency.
However, taking a CPR certification course can give you the knowledge and confidence to respond quickly and correctly. You’ll also learn how to:
- Recognize cardiac arrest.
- Perform high-quality CPR.
- Use an AED safely.
- Help choking victims.
- Provide rescue breaths effectively.
Doctors, nurses, teachers, childcare workers, coaches, lifeguards, and many employers require formal CPR certification, but these skills are valuable for everyone.
Frequently Asked Questions
How do you know if someone needs CPR?
If the person is unresponsive: Look, listen, and feel for signs of circulation. If there are none, begin CPR.
Can CPR restart the heart?
No, except for some cases of cardiac arrest caused by a lack of oxygen. The purpose of CPR is ty buy time until EMS arrives and advanced care can be provided.
Is hands-only CPR enough?
Hands-only CPR has been proven to be extremely effective and has saved thousands of lives. It can absolutely help buy time until EMS arrives.
Can CPR break ribs?
Yes, it is a normal complication from CPR. It can happen even when CPR is performed correctly, especially in older adults. People can survive a broken rib, they can not survive cardiac arrest.
What is the correct CPR compression rate?
The correct rate of compressions is 100 to 120 per minute.
Final Thoughts
Knowing how CPR is performed can make the difference between life and death. The process is straightforward: recognize cardiac arrest, call 911, begin hard and fast chest compressions, provide rescue breaths, and use an AED as soon as one is available. If you don’t have a mask or barrier device or you’re not comfortable with it, hands-only CPR is still an effective way to help.
The best time to learn CPR is before an emergency happens. Training builds confidence, improves technique, and prepares you to act when someone needs you most. Take on of our free CPR courses and learn how to save a life today!