If someone collapses in front of you and stops breathing normally, what you do in the next few minutes can decide whether they live. Most cardiac arrests outside hospital happen at home, and the person nearest is usually a family member. Immediate CPR can double or even triple the chance of survival, according to the American Heart Association.
Picture this: your father collapses at the dinner table. Most people freeze. You kneel down, call for help and start pushing on his chest, because you read this guide. That is the person this article will help you become.
Remember: you cannot make things worse. Without CPR, a person in cardiac arrest will die. Pushing hard and fast on the chest keeps blood flowing to the brain until help or a defibrillator arrives.
The 5 steps of adult CPR
- Check for danger, then response. Shout and gently shake their shoulders. If they do not respond, open the airway by tilting the head back and lifting the chin.
- Check breathing for no more than 10 seconds. Occasional gasps are not normal breathing; treat them as cardiac arrest.
- Call your emergency number and put the phone on speaker. The call handler will guide you. Send someone to find an automated external defibrillator (AED) if one is nearby.
- Push hard and fast in the centre of the chest. Place the heel of one hand on the lower half of the breastbone, your other hand on top, arms straight. Press down 5–6 cm, at 100–120 compressions a minute (the beat of the song “Stayin’ Alive”), letting the chest rise fully between pushes.
- Use the AED as soon as it arrives. Switch it on and follow the spoken instructions. Keep doing compressions while the pads are attached, and do not stop until the person starts breathing normally or professional help takes over.
Do I have to give rescue breaths?
If you are untrained or unwilling, hands-only CPR (compressions without breaths) is far better than doing nothing. If you are trained and willing, give 30 compressions followed by 2 rescue breaths, and repeat.
CPR on children and babies
Children usually arrest because of a breathing problem, so breaths matter more. UK guidance advises trained rescuers to give 5 rescue breaths first, then 30 compressions to 2 breaths if you are a lay rescuer. Press one-third of the depth of the chest: with one or two hands for a child, and two fingers or two thumbs for a baby. If you only know adult CPR, use it; doing something is always better than nothing.
Common mistakes that cost lives
- Waiting too long to start because you are afraid to hurt them
- Pressing too gently or too slowly
- Stopping to check for a pulse again and again
- Not using the defibrillator because you think you need training (you do not; it talks you through)
- Tiring out: swap with someone every 2 minutes if you can
Learn it properly
A short practical course with a manikin is the best way to feel confident. Many hospitals, Red Cross and Red Crescent societies and community groups offer free or low-cost training. Nurses can help by teaching family members, especially of patients with heart disease.
“But what if I break a rib?”
It can happen, especially in older people, and it is a sign you are pressing hard enough. Broken ribs heal. Without CPR, a person in cardiac arrest will not survive. In many countries, good-faith rescuers are also protected by law.
Your next step: share this with the people you live with tonight, then book a practical CPR class. The more people in your home who know CPR, the safer everyone is.
Related: Choking first aid · Signs of a heart attack
Sources: Resuscitation Council UK, Adult and paediatric basic life support guidelines (2021); American Heart Association CPR and ECC guidelines; European Resuscitation Council Guidelines 2021. This guide does not replace a practical first aid course.
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