Cardiopulmonary resuscitation (CPR) is an emergency, life-saving procedure for cardiac arrest. This hands-on intervention helps maintain blood flow and, in some cases, breathing until medical help arrives.

When Should You Perform CPR?

You can perform CPR when someone’s heart stops, or if they have stopped breathing and do not have a pulse. CPR helps when a person has cardiac arrest. A heart attack, near-drowning, injury, or trauma can cause cardiac arrest.

During cardiac arrest, the heart stops beating and is unable to pump blood to the rest of the body, including the brain and lungs. Without help, the person can die within minutes.

Doing chest compressions manually pumps the heart and keeps blood flowing until medical help arrives.

Cardiac arrest is different from a heart attack.

A person having a heart attack will be conscious and breathing. Immediate medical care helps prevent permanent damage that increases the risk of cardiac arrest.

Before you perform CPR, do the following:

• Assess the situation, and ensure it’s a safe location.
• Quickly check if the person is responsive, breathing, or has any life-threatening injuries.
• Call 911. If someone is with you, have them call 911 so you can start chest compressions right away.

How Do You Perform CPR Safely?

The recommended order for CPR is to perform chest compressions and then check the airway and address breathing. Think of the acronym C-A-B: compressions, airway, breathing.

People who are not trained can only give chest compressions, or hands-only CPR. In other words, you would only need to worry about the first letter of the C-A-B acronym.

How To Do Hands-Only CPR

Begin performing chest compressions as soon as possible with the following steps:

• Make sure the person is flat on their back on a firm surface.
• Kneel beside them with your knees shoulder-width apart.
• Place the heel of your hand in the center of their chest, and interlace your fingers.
• Lock your elbows and keep your arms straight. Keep your shoulders directly over your hands.
• Push hard and fast, allowing their chest to return to its normal position after each compression.
• Perform consistent compressions, going at least 2 inches deep at 100-120 beats per minute.
• Continue until medical help arrives.

How To Do Rescue Breathing

You can prepare the airway and give rescue breaths, also known as mouth-to-mouth, if you have had training and feel comfortable. To do this, perform 30 chest compressions and then give two rescue breaths.

Perform rescue breathing with the following steps:

• Open the airway. Place your palm on the person’s forehead and your fingers under their chin. Press back on their forehead while gently lifting their chin with your fingers. Lift their chin until the airway is past the neutral position.
• Listen for normal breathing, or see if their chest is rising. Gasping sounds are not a sign of normal breathing.
• Pinch their nose with your thumb and forefinger, and make a seal with your mouth if the person is at least 1 year old.
• Breathe into their mouth, and watch their chest rise.
• If their chest does not rise, tilt their head again. Make sure you have a proper mouth seal before giving a second breath. There may be an object blocking the airway if their chest does not rise again.
• Return to chest compressions. Repeat the process after 30 compressions until help arrives or an automated external defibrillator (AED) is available.

Is CPR Different for Children?

While hands-only CPR is recommended for adults and adolescents, using both chest compressions and rescue breathing is best for children and infants. Rescue breathing helps improve oxygen flow and prevent brain damage.

It may be helpful to get certified in CPR if you are a parent, caregiver, babysitter, or work with children.

Instructions for Children

Before performing CPR on a child, make sure the location is safe and get permission from the parent if possible. Use personal protective equipment (PPE) if you have it on hand.

Here’s how to perform CPR on a child:

• Shout to get their attention, or tap on their shoulder and check for breathing.
• Call 911, or ask another bystander to call for help while you begin CPR.
• Place the heel of your hand in the center of their chest, and interlace your fingers. If the child is small, use one hand.
• Continue until medical help arrives or an AED is ready to use.

Instructions for Infants

As with CPR for children, check if the location is safe, get the parents’ permission if possible, and use PPE if you have it available.

Here’s how to perform CPR on an infant:

• Shout to get the infant’s attention, or tap the bottom of their foot and check for breathing.
• Call 911, or ask another bystander to call for help while you begin CPR.
• Use two fingers placed parallel to the chest to do chest compressions. You can also place both thumbs side by side and use your other fingers to encircle the infant’s chest and toward their back.
• Push hard and fast, allowing their chest to return to its normal position after each compression.
• Perform 30 consistent compressions, going about 1.5 inches deep at 100-120 beats per minute.
• Use the head-tilt/chin-lift technique to open the airway to a neutral position. Do not move their head past neutral like you do for children and adults. This could close the airway.
• Place your mouth over both the infant’s nose and mouth. Puff lightly into their mouth, watching for their chest to rise.
  Continue until medical help arrives.