CPR
The chain of survival
Recognize arrest early, activate emergency response, start high-quality CPR, use an AED as soon as it arrives, and hand off to advanced care. For an adult who is unresponsive and not breathing normally, begin compressions immediately.
High-quality compressions
Place the heel of one hand on the lower half of the sternum with the other hand on top, arms straight, shoulders over your hands. Compress at least 2 inches (about 5 cm) deep for an adult, at a rate of 100–120 per minute, allowing full chest recoil and minimizing interruptions. Give 30 compressions to 2 breaths. If you are unwilling or unable to give breaths, perform compression-only CPR. For children, use one or two hands as needed; for infants, use two fingers or two thumbs encircling the chest, compress about one-third the depth of the chest, and give 30:2 for a single rescuer.
Traps to watch
Questions often confuse rate with depth, or ask what to do when a victim gasps. Agonal gasps are not normal breathing-start CPR. Do not delay compressions to check a pulse for a long time; if unsure, begin CPR. Switch compressors about every 2 minutes to limit fatigue.
Rule of thumb
Push hard, push fast, let the chest come all the way back up, and keep interruptions short.
Worked example
An adult collapses and is unresponsive with occasional gasps. Send someone for the AED and begin 30:2 compressions at 100–120 per minute, at least 2 inches deep.