Cardiopulmonary resuscitation (CPR)

What is cardiopulmonary resuscitation (CPR)?#

Cardiopulmonary resuscitation (CPR) is used in an emergency when someone is not breathing normally or their heart has stopped (cardiac arrest). It combines two techniques: chest compressions and rescue breathing (mouth-to-mouth). CPR helps keep blood circulating and delivers oxygen to the body until specialist treatment is available.

There is usually enough oxygen left in the blood to keep the brain and other organs alive for a few minutes, but that blood will not circulate unless someone performs CPR.

Why learning basic first aid and CPR matters#

There is no guarantee that someone will survive after receiving CPR, but it gives them a chance when otherwise there would have been none.

Without CPR, it takes only a few minutes for the brain to be injured by a lack of oxygen. In an emergency, a person’s condition can deteriorate quickly. Always seek help for any life-threatening sign, including serious accidents or trauma.

Calling for an ambulance#

Call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) for an ambulance whenever you need medical help. Some people hesitate to call because they are not sure their situation counts as an emergency.

If in doubt, call#

When in doubt, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) . Emergency phone operators are trained to help you and can advise you on what to do while you wait for emergency services to arrive.

What you will be asked#

When you call, you will be asked which service you need. Tell the operator you need an ambulance. You will then be connected to an ambulance operator and asked for details such as:

• The location where the ambulance is needed. If you know the address, give it. If you do not, share any information that may help — street or road names, parks, or nearby landmarks.
• Details of the situation and what has happened.
• How many people need medical assistance.
• The injured person’s age and sex.
• Whether the person is conscious and whether they are breathing.

The operator will arrange help while you keep talking on the phone, even though you may not hear them do this. Answering their questions helps the paramedics prepare before they arrive, and the operator may give you first aid instructions over the phone.

If you can, put your phone on loudspeaker. Do not hang up until the operator tells you to.

When is CPR needed?#

CPR is most effective when started as soon as possible. It is needed when a person is not breathing or not breathing normally. A person in cardiac arrest may grunt, snort or take gasping breaths — this is not normal breathing, and they still need CPR. Do not wait until they stop breathing completely.

The CPR steps are the same for adults and older children, but the technique for babies and young children (0–5 years) is slightly different.

The DRSABCD steps#

The steps in CPR are remembered as DRSABCD (you can think of it as “doctors ABCD”):

• D — Danger: Look for any source of danger and make sure you and the person are safe.
• R — Response: Check for a response, as if trying to wake them — speak loudly, gently squeeze them, or, for a baby, tickle their feet.
• S — Send for help: If there is no response, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) and ask for an ambulance. Do not leave the person unattended. The operator can guide you through CPR until the ambulance arrives.
• A — Airway: Check the airway (nose, mouth and throat) is clear.
• B — Breathing: Check whether they are breathing normally.
• C — CPR: Give chest compressions and rescue breaths.
• D — Defibrillator: Continue CPR until an automated external defibrillator (AED) is available and ready.

How to give CPR to babies (0–12 months)#

• Airway: Check the baby’s airway (nose, mouth and throat) is clear, and remove any blockage such as vomit, blood, food or loose teeth. Keep the baby in a neutral position, such as on their back, with the head and neck in line. Do not tilt the head back or lift the chin.
• Breathing: Is the baby breathing normally? If so, gently roll them onto their side (the recovery position). If they are not breathing or are breathing abnormally (such as grunting or gasping), you will need to perform CPR.

Chest compressions#

Lie the baby on their back. Place 2 fingers on the lower half of the breastbone, in the middle of the chest. Press down to about one third of the depth of the chest, then release back to the resting position. This counts as one compression. Depending on the size of the baby, you may need to use the palm of your hand instead of two fingers (a palm is suitable for babies over 6 months).

Rescue breaths#

Make sure the baby is in the neutral position and the head and neck are not tilted. Gently lift the chin, taking care not to press on the throat, as this can block air from reaching the lungs. Take a small breath, cover the baby’s nose and mouth with your mouth, and blow gently for about one second while watching for the chest to rise.

After each breath, watch for the chest to fall and place your face close to the baby’s nose and mouth to feel whether air is being expelled. If the chest is not rising, check again for blockages and remove them.

Continue giving 30 chest compressions followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes. Keep going until the baby recovers — starts to move, breathe normally, cough or cry — or the paramedics take over. If the baby recovers, place them in the recovery position on their side.

If you find it hard to keep up mouth-to-mouth breathing, keep going with compressions — they can still save the baby’s life.

How to give CPR to young children (1–5 years)#

• Airway: Check the airway is clear and remove any blockage. Keep the child in a neutral position on their back, then gently tilt the head back and lift the chin.
• Breathing: Is the child breathing normally? If so, gently roll them onto their side (the recovery position). If not, you will need to perform CPR.

Chest compressions#

Lie the child on their back and kneel beside them. Place the heel of one hand on the lower half of the breastbone in the middle of the chest. Position yourself above the chest, keep your arm straight, and press down to about one third of the chest depth, then release. This counts as one compression.

Rescue breaths#

Open the airway by placing one hand on the forehead and the other on the chin to tilt the head back. Pinch the soft part of the nose closed, then open the mouth. Take a breath, place your lips over the child’s mouth with a good seal so no air escapes, and blow steadily for about one second while watching for the chest to rise.

After each breath, watch for the chest to fall and listen and feel for air being expelled. Keep the chin lifted and head tilted, take another breath and repeat. If the chest is not rising, check again for blockages and remove them.

Continue with 30 compressions to 2 breaths (30:2), aiming for 5 sets in about 2 minutes. Keep going until the child recovers — starts to move, breathe normally, cough or talk — or the paramedics take over. If the child recovers, place them in the recovery position on their side.

If you cannot do mouth-to-mouth, continue with chest compressions at a rate of about 100 per minute. They can still save the child’s life.

How to give CPR to adults and older children#

• Airway: Open the airway (nose, mouth and throat) and check it is clear. Remove any blockage such as vomit, blood, food or loose teeth, but do not spend too long on this — compressions are the priority. Keep the person in a neutral position on their back, then gently tilt the head back and lift the chin.
• Breathing: Are they breathing normally? If so, gently roll them onto their side (the recovery position). If not, you will need to give CPR.

Chest compressions#

Place the heel of one hand on the lower half of the breastbone in the middle of the chest. Place your other hand on top and grasp your wrist, or interlock your fingers — whichever is comfortable. Keep your arms straight and press down by about one third of the chest depth, then release. This counts as one compression. To keep the right rhythm, you can hum a song with a steady beat.

Rescue breaths#

Make sure the person is lying on their back on a firm surface. Open the airway by tilting the head back and lifting the chin. Close their nostrils with your finger and thumb, put your mouth over theirs, and give 2 full breaths (rescue breathing), making sure no air leaks. Check that the chest rises and falls with each breath.

If the chest does not rise, tilt the head back again, pinch the nostrils tightly and re-seal your mouth to theirs. If there is still no chest movement, check the airway for any obstruction. If you cannot get air into the lungs, return to chest compressions — this may help dislodge an obstruction.

Continue with 30 compressions to 2 breaths (30:2), aiming for 5 sets in about 2 minutes. Keep going until the person becomes responsive — they may move, breathe normally, cough or talk — or the paramedics take over. If they recover, place them in the recovery position on their side.

Sharing the effort#

CPR is tiring. If you need a break, ask someone else to take over with minimal disruption, and rotate the person doing compressions every 2 minutes. If you find mouth-to-mouth difficult, continue with chest compressions until medical help arrives — they can still save a life.

Can chest compressions be dangerous?#

Chest compressions sometimes break a person’s ribs. This is still far better than not receiving CPR. If it happens, pause to reposition your hands before continuing, or ask someone else to take over.

Defibrillators (AEDs)#

A defibrillator is a life-saving device used when someone is in cardiac arrest. It can analyze abnormal heart rhythms and deliver an electric shock to help the heart return to its normal pumping rhythm.

Continue CPR until an automated external defibrillator (AED) is available, the pads are attached to the skin, and the machine is turned on. AEDs are easy to use — voice prompts tell you what to do — and they are increasingly found in public places such as shopping centers and schools. It is important to follow the AED’s prompts, and you must not touch the person during rhythm analysis or shock delivery.

Consider taking a first aid course#

Knowing simple first aid can mean the difference between life and death. CPR increases someone’s chance of survival until an ambulance arrives. First aid training is widely available, often as a course lasting a couple of hours that can be taken online or in person, with flexible times. Participants learn basic first aid skills, including CPR, and usually receive a certificate. Refresher courses are recommended every few years. Ask your doctor or a child health nurse for more information.

Key points#

• CPR keeps blood circulating and delivers oxygen to the body until specialist treatment is available.
• Knowing basic first aid and CPR can be life-saving.
• The steps are remembered as DRSABCD — Danger, Response, Send for help, Airway, Breathing, CPR, Defibrillator.
• Give 30 chest compressions to 2 rescue breaths, aiming for 5 sets in about 2 minutes; if you cannot do rescue breaths, keep doing compressions.
• Continue CPR until the person recovers, an AED is ready, or paramedics take over — and always follow the AED’s voice prompts.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).