How to Do CPR
Step-By-Step Instructions for Adults, Children, and Babies
Medically reviewed by Jordana Haber Hazan, MD
Cardiopulmonary resuscitation (CPR) is a hands-on emergency intervention used to restore heartbeats and breathing in someone who has gone into cardiac arrest. Common causes of cardiac arrest are a heart attack or near-drowning.
CPR involves manual chest compressions and, in some cases, rescue ("mouth-to-mouth") breathing. If available, a device called an automated external defibrillator (AED) may be used to restart the heart. These interventions can keep blood flowing to the brain until emergency medical assistance arrives.
This article provides steps for performing CPR on an adult, child, or baby. It also describes how rescue breathing is done and how to use an AED.
When to Do CPR
Cardiopulmonary resuscitation (CPR) is used on someone with cardiac arrest. This is when the heart stops beating, causing the person to collapse, lose consciousness, and stop breathing.
By applying external pressure on the chest, you can manually pump the heart and keep blood flowing until emergency help arrives. CPR can be performed on people of any age.
CPR is needed when a person has the four signs of cardiac arrest:
The person has collapsed.
The person is non-responsive.
Breathing has stopped.
There is no pulse.
Performing CPR on someone with cardiac arrest doubles or triples their chances of survival,
Related:AHA Issues New Guidelines for Performing CPR During Pandemic
What to Do Before Performing CPR
Before starting CPR:
Make sure that you and the victim are well away from traffic, fire, or any other hazard.
Ask the person loudly if they are OK to see if they are responsive.
If not, call 911 or ask a bystander to do so.
If available, ask someone to get or find an AED (often available in public facilities).
Turn the person on their back and check if they are breathing by listening for breathing sounds or seeing if their chest rises and falls.
Check for a pulse on the person's neck.
If there is no pulse, start CPR.
All of these tasks can be performed in less than a minute.
A rapid response is needed as permanent brain damage can occur after only 4 minutes without oxygen. Death can occur as soon as 4 to 6 minutes later.
CPR Step-by-Step Instructions
CPR procedures vary based on the age of the victim as well as the training of the person performing CPR. According to the American Heart Association:
CPR with rescue breaths can be performed if you are formally trained in CPR.
Hands-only CPR is recommended if you have no CPR training or are not confident in your skills.
Related:Why the CPR Guidelines Changed
CPR in Adults and Older Children
The following steps apply to adults and children over 8 years old.
Place one hand on the middle of the person’s chest just below the nipples. Place the other hand on top, locking fingers.
Using your body weight, push hard with the heel of your hand. You need to push hard enough to compress the chest to a depth of around 2 inches. Keep your arms straight.
Keep compressing at a rate of 100 to 120 beats per minute. The easiest way to do so is by pushing to the rhythm of the Bee Gee's "Staying Alive," Johnny Cash's "Ring of Fire," or Beyeonce's "Crazy in Love."
If you are qualified to give rescue breaths, do chest compressions for 30 seconds, followed by two rescue breaths, followed by another set of chest compressions, and so on. If you are not, keep doing chest compressions without rescue breaths.
If another person is available to help, they can take over if you get tired.
Continue until emergency medical help arrives or the person revives.
CPR for Children 1 to 8 Years
The procedure for giving CPR to a child is essentially the same as that for an adult.
Place one hand in the middle of the child’s chest on the breastbone.
Push hard with your hand, compressing the chest to a depth of around 2 inches.
Keep compressing at a rate of 100 to 120 beats per minute.
If you are qualified to give rescue breaths, do chest compressions for 30 seconds, followed by two rescue breaths, followed by another set of chest compressions, and so on. If not, keep doing chest compressions without rescue breaths.
Continue until emergency medical help arrives or the child revives.
CPR for Infants
With infants, check for responsiveness by flicking the bottom of their foot. If the infant is non-responsive and there are no signs of breathing or a heartbeat, proceed as follows:
Place two fingers in the center of the infant's chest.
Firmly compress the chest about 1-1/2 inches deep at a rate of around 120 beats per minute.
If you are qualified to give rescue breaths, do chest compressions for 30 seconds, followed by two rescue breaths, followed by another set of chest compressions, and so on. If, do chest compressions without rescue breaths.
Continue until emergency medical help arrives or the infant revives.
Related:Why CPR Without Rescue Breaths Is OK
Rescue Breathing Step-by-Step Instructions
Rescue breathing is not advised for people untrained in CPT because it is not proven to save lives. Doing so may put the person at risk by interrupting the flow of blood to the brain.
If you are skilled in CPR, adding rescue breaths ensures that the person's blood is oxygenated and the blood flow is sufficient. If you are not skilled and end up doing one or both procedures insufficiently, you may put the person at risk.
Rescue Breaths for Adults And Children
Rescue breathing is performed in the following way:
Check that the person's mouth is clear. If there is a visible obstruction, try to fish it out with your fingers.
Tilt the person's head back slightly and lift their chin.
Pinch their nose shut.
Place your mouth fully over theirs.
Blow forcefully to make their chest rise.
If their chest does not rise, tilt their head back a little further and try again.
Rescue Breaths for Infants
Rescue breathing is slightly different for infants:
Check that the infant's mouth is clear. If there is a visible obstruction, try to fish it out with a finger.
Tilt the infant's head back slightly and lift their chin.
Place your mouth fully over their nose and mouth.
Blow forcefully to make their chest rise.
If their chest does not rise, tilt their head back a little further and try again.
Related:How to Perform Rescue Breathing
Using an AED
Automatic external defibrillators (AEDS) are used to restart a stopped heart with a strong pulse of electricity. Using an AED within the first 3 to 5 minutes of cardiac arrest dramatically increases the survival rate.
AEDs are frequently installed in public facilities in the event someone experiences cardiac arrest. In such situations, there should be a person or persons in the facility trained in CPR and AED use.
While an AED is relatively easy to use, there are many different models, and the American Heart Association advises that only people formally trained in CPR and AED use them.
Children over 8 years can be treated with a standard AED. Children age 1 to 8 years require special defibrillator pads.
AEDs are not used on children under 1 year of age or on someone with a pulse.
How to Get Certified in CPR
You can get certified in CPR by meeting the requirements of a CPR training program. These programs are offered in-person, online, or as a hybrid of both.
Classes are typically completed in two hours, depending on which format you choose (online or in-person). Once you have completed the class, you will be given a certificate.
CPR training courses are offered by hospitals, community centers, and national organizations such as the American Red Cross and the American Heart Association.
Not every CPR class is the same. There are CPR classes for healthcare professionals as well as CPR classes for the layperson. Before you take a CPR class, make sure the class is right for you.
