CPR Steps and When to Use This Life-Saving Technique

CPR should be performed when an adult is unresponsive or gasping for breath.

For infants and children, CPR should be used if they are unresponsive or not breathing normally.

Some situations in which you may need to perform CPR include cardiac arrest, choking, drowning, suffocation, drug overdose, or electrocution.

The first thing you do before performing CPR is check the scene for safety. Look for hazards, like traffic, downed electrical wires, or dangerous substances.

Not only can this give you an idea of what happened and how the person was injured, but it also ensures that both the victim and the rescuer are safe from injury.

If the person appears unresponsive, check for responsiveness first. Shout, "Are you okay?" and tap them to see if they are arousable. If they are not, it is time to initiate CPR. If you are alone, call 911 before beginning. If other people are on the scene, direct one of them to call 911 and start CPR right away.

If you are in a public place and there is an automated external defibrillator (AED) on-site, direct someone to retrieve it. An AED is a portable, easy-to-use device that analyzes a person's heart rhythm. It delivers an electric shock when necessary to restore normal heart rate.

If you are the only person on-site, do not leave the victim to get the AED. Instead, start CPR right away.

To open the airway, first, make sure the person is lying on their back. Gently tilt their head back and lift their chin to open the airway.

Look into the mouth to ensure that nothing is blocking the airway. Remove any visible loose objects, but do not sweep your finger into the back of the mouth or reach deep into the throat.

If something is blocking the airway, these actions can push the object deeper.

Check for breathing and a pulse. Place your ear to the person's mouth and watch their chest for movement for no longer than 10 seconds.

If they are not breathing, ensure that someone has called 911 and that emergency medical services are on their way. Then, begin CPR.

Chest compressions are the most important step in CPR. To do them, first, place the person on their back on a firm surface. Place the lower palm of one hand in the center of the chest, over the breastbone. Place your other hand over the first hand, keeping your elbows locked and shoulders above your hands.

Push straight down using your body weight—not just your arms—with elbows locked. Do 100 to 120 compressions a minute, allowing the chest to recoil between each one. To help you deliver compressions at the right rate, you can follow the beat of many popular songs, including "Stayin' Alive," "Walkin' on Sunshine," "Dancing Queen," and "I Will Survive."

If you have not been officially trained in CPR, continue doing chest compression until there are signs that the person is coming to or until emergency services arrive. If you are trained in CPR, start rescue breaths after 30 compressions.

To give rescue breaths, tilt the head back, pinch the nose, and seal your mouth over theirs. Blow until you see chest rise.

You may need to lift the jaw. Give two breaths, and then go back to compressions.

Continue the cycle of 30 compressions and two rescue breaths until the person begins breathing, help arrives, or an AED is available.

AEDs are designed to be user-friendly. When turned on, it will give step-by-step voice instructions, including instructions on how and when to place the AED pads.

After the pads are in place, the AED will tell you to stand clear as it analyzes the person's heart rhythm. If a shock is advised, it will tell you to step back and push a button to deliver the shock. Remember that the AED will only deliver a shock when needed, and ensure that no one is touching the person when delivering a shock.

After a shock, continue CPR. The AED will guide you, telling you when to stop so that it can analyze the person's rhythm. Repeat the process, following the AED's prompts, until emergency services arrive.

CPR is very physical and can be exhausting for the rescuer. If two people are available, they should switch off doing chest compressions every two minutes.

Hands-only CPR is an option for those who aren’t trained or feel uncomfortable giving rescue breaths. In the first few minutes after cardiac arrest, it is just as effective as conventional CPR.

To do it, first, call 911, then begin chest compressions. Again, aim for 100 to 120 compressions per minute. Instead of stopping to deliver rescue breaths, continue compressions until help arrives. If two rescuers are on-site, switch off compressions every two minutes.

CPR for children between ages 1 and 8 is similar to adult CPR, with some modifications. First, check the scene for safety, then assess the child. If they are unresponsive and you are not alone, direct someone else to call 911 and get an AED if available. If you are alone, begin CPR immediately, then call for help after two minutes.

Place the child on their back. If a spinal injury is suspected, two people should carefully roll the child to keep the neck stable.

Hand positioning varies depending on the size of the child. You can use the same hand placement as you would for an adult or, for smaller children, you can use the heel of your hand.

Ensure you can press hard enough to compress the chest about two inches or about a third to a half of the depth of the chest, allowing the chest to rise completely between compressions.

The pattern is the same with one rescuer as with adults: thirty compressions followed by two rescue breaths. If two rescuers are available, the child should receive 15 compressions followed by two rescue breaths.

After two minutes, if you are alone and the child is still unresponsive, call 911 and then resume CPR. If an AED is available, use it at this time.

Infant CPR is also similar to adult and child CPR, with some modifications.

As with children, if you find an infant unresponsive and are alone, start CPR right away. After two minutes, leave the infant to call 911. If another person is present, direct them to call 911 and retrieve an AED if one is available

Place the infant on their back to begin CPR. If a spinal injury is suspected, two people should position the infant to prevent twisting the neck. For chest compressions, place two fingers on the infant's breast bone, just below the nipple line, and compress the chest about one-third to one-half the depth of the chest.

Give 30 quick compressions, allowing the chest to rise completely between each one. Then, give two rescue breaths, covering either the nose and mouth or just the nose and holding the mouth closed with the chin lifted.

If two rescuers are present, the infant should receive 15 chest compressions followed by two rescue breaths.

After two minutes, stop and call 911 if you are alone, and use an AED if available.