You might’ve seen someone perform cardiopulmonary resuscitation (CPR) on TV or even in person. But what exactly is CPR — and when should you use it? Let’s find out.
Jump ahead to these sections:
- When Do You Perform CPR?
- When Should You Not Perform CPR?
- Who Can Perform CPR?
- Steps to Administer CPR
CPR is a life-saving intervention for people who experience cardiac arrest. During cardiac arrest, a person’s heart stops beating and his or her breathing may stop.
As a result, the heart cannot pump blood to the rest of the body. Vital organs such as the brain and lungs can no longer be supported. Without adequate blood flow and oxygen, someone can sustain permanent brain damage or die in under 8 minutes.
This is where CPR comes in. Using your hands, you can perform chest compressions that mimic the way the heart pumps. You can perform the job of the heart and maintain circulation and breathing while waiting for emergency medical help to arrive.
How do you know you’ve come across someone who needs CPR? Most cardiac arrests happen at home or in public places. You can tell when someone is in cardiac arrest if:
- The person is unresponsive, even when you shake or shout at them.
- The person is not breathing or only gasping.
If you see someone with these signs, call 911 right away and then start CPR. Your chest compressions will help maintain blood flow until professional medical help arrives.
Here are some examples of when you might find someone in need of CPR:
- Cardiac arrest: You may witness a sudden collapse. The person will be unresponsive, and may not be breathing or have a pulse.
- Road traffic accident: A person may become unresponsive due to trauma.
- Electrocution: You may see someone undergo cardiac arrest because he or she has been electrocuted. Try to kill the power source or remove the victim from the electrical contact without directly touching him or her. Use something that doesn’t conduct electricity, like a wooden broom or stick. Prioritize your own safety — always make sure the scene is safe!
- Choking, suffocation, drowning: Choking can lead to suffocation. CPR can relieve obstructions of the airway when foreign objects prevent normal breathing. In this case, the Heimlich maneuver should be performed before CPR if the person coughing but is unable to cough up the object. The Heimlich maneuver involves placing one hand over the other in a fist. You’ll thrust inward and upward into the victim's abdomen with forceful, quick jerks. The person may be or may become unresponsive. In this case, begin CPR immediately. CPR can also help maintain oxygen flow to the body following an episode of near-drowning or other types of suffocation.
- Poisoning, drug or alcohol overdose: An overdose of certain substances can depress brain and heart function. CPR will manually keep the heart pumping and help maintain adequate oxygen flow to the body until help arrives.
- Suspected sudden infant death syndrome (SIDS): You can perform CPR in children and infants when they are not breathing normally.
Whether a person receives CPR or not can also be determined by a designated health care proxy, otherwise known as medical power of attorney. A health care proxy or medical power of attorney is your legally bound health care agent that you choose ahead of time to make medical decisions for you in the event that you become incapacitated or unable to make decisions.
For example, if a stroke leaves you unable to move and then your heart stops, would you want CPR? What if the stroke leaves you mentally impaired? Would you still want CPR? If not, you can create a do not resuscitate (DNR) order that tells medical staff in a hospital or nursing facility that you do not want them to try to return your heart to a normal rhythm if it stops or is beating irregularly.
Preparing end-of-life planning documents will allow you to specify your health care preferences, including whether you would want to have CPR if a physician determines that you have an incurable illness or injury. These documents are crucial to guide the decisions of your health care proxy or power of attorney.
You must not perform CPR on someone if you know they’ve signed a DNR order — though it’s not always possible to know whether someone has one or not, particularly if disaster strikes in a public area and you don’t know the person who needs CPR.
High-quality CPR can be performed by anyone (even children), even if you haven’t had formal training.
You can get CPR certified by finding an in-person training class near you through the American Heart Association or through the American Red Cross. Undergoing CPR training does not give you a legal obligation to perform it in an emergency, especially if the situation is unsafe.
Here are some fundamental tips to know in order to make sure you can perform CPR safely and properly.
Step 1: Make sure the scene is safe
Let’s say you see someone who you suspect needs CPR. You should always make sure the scene is safe first.
Watch out for traffic, power lines, smoke, a slippery surface, sharp objects, and take your personal safety into account. Call for help first if you’re unsure of your own safety.
Step 2: Check the victim for unresponsiveness
A victim will lose consciousness within 10 seconds of cardiac arrest. Shaking or shouting at the victim won’t get a response. Sometimes, the person displays abnormal breathing. They may make grunting, gasping, or snoring sounds.
Flick the bottom of an infant’s foot to check if he or she is responsive and check for breathing. Only use CPR after you check that the person is unresponsive to verbal or physical stimuli.
Step 3: Call 911
Call for help immediately and begin CPR. Use the speaker on your phone — in most locations, the emergency dispatcher can assist you with CPR instructions.
Step 4: Begin chest compressions
Place the victim on his or her back. Push down hard in the center of the chest to a depth of at least 2 inches. Place the heel of one hand on the breastbone, just below the nipples, and place the other hand on top. This will help you apply adequate force.
Use two fingers for infants instead and still apply adequate force for a depth of slightly less than 2 inches. The compression rate should be about 100 to 120 pushes a minute.
The American Heart Association recommends pushing to the beat of the song “Stayin’ Alive” by the Bee Gees — this will help you maintain the appropriate compression rate. After each compression, make sure to let the chest come back up to its normal position.
This will allow blood to flow back into the heart and lungs before the next push. Switch off with other bystanders (if available) after a few rounds of compression — CPR is tiring! Alternate who gives CPR to ensure that compression rates and depth are maintained.
Step 5: Blow
Healthcare providers and those trained can perform chest compressions and mouth-to-mouth breathing at the conventional CPR ratio of 30:2 compressions-to-breaths. Tilt the head back for mouth-to-mouth breathing. Press on the forehead and lift the chin with two fingers.
Pinch the nose and cover the mouth with yours. Blow until you see the chest rise. Give 2 breaths, each for 1 second. Maintain a 30:2 compression-to-breath ratio until help arrives.
For the general public or bystanders who witness an adult suddenly collapse, compression-only CPR, or hands-only CPR without mouth-to-mouth breaths, is recommended.
Share your final wishes, just in case.
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Anyone Can Save a Life
Death could be minutes away when a person becomes unresponsive and their heart stops beating and their breathing stops.
CPR is a life-saving intervention and is crucial following cardiac arrest and other dangerous events such as electrocution, near-drowning, and drug overdose that stops blood flow. Beginning CPR will maintain blood flow to the brain and other important organs while you are waiting for emergency medical help.
Keep these tips in mind for high-quality CPR:
- Always make sure the scene is safe.
- Minimize interruptions in chest compressions.
- Provide compressions of adequate rate and depth (Maintain compression rate of about 100 to 120 pushes a minute — to the beat of “Stayin’ Alive.” Maintain a compression-to-breath ratio of 30:2.)
- Avoid leaning on the victim between compressions.
- Ensure proper hand placement.
- Avoid excessive ventilation — keep the heart pumping with compressions. It’s more important than giving breaths.
Whether you are healthy or sick, it is important to prepare for unexpected events by designating a health care proxy and medical power of attorney in the event that you may need CPR but are unable to express your end-of-life wishes. Doing so will help avoid confusion in urgent or uncertain situations.
Every second counts. Save a life and learn how to perform CPR in the right situations — you can always watch videos or take a class so you can ensure you know what you’re doing.