How To Perform Cpr On An Adult Steps And Tips? Key Facts

Cardiopulmonary resuscitation, or CPR, is a set of actions that keeps blood and oxygen moving to the brain when a person’s heart has stopped. For an adult, the core of CPR is hard, fast chest compressions at the center of the chest, pushing at least 2 inches deep at a rate of 100 to 120 per minute. If you are trained and willing, you add rescue breaths and use an automated external defibrillator (AED) as soon as one is available.

Those numbers come from the American Heart Association, the organization whose guidelines most US CPR training follows. The steps below walk through what to do in order, what to skip if you are unsure, and the mistakes that quietly make CPR less effective.

How Do You Know Someone Needs CPR?

You start CPR when a person is unresponsive and not breathing normally. That is the trigger. Nothing else needs to be confirmed before you begin.

Check responsiveness by tapping the person’s shoulders and shouting. If there is no response, call 911 or direct someone nearby to call, and send another person to find an AED. Then look at the chest for breathing for no more than about 10 seconds.

Agonal gasps are the detail most people miss. These are irregular, gasping, snoring sounds that can appear in the first minutes after the heart stops. They are not normal breathing, and a person making them needs CPR. A common mistake is to assume the gasps mean the person is breathing and hold off. If you are not sure whether breathing is normal, treat it as not normal and start compressions.

What Are the Steps To Perform CPR On an Adult?

The sequence is straightforward once you know it: check, call, compress, and add breaths and an AED when you can.

• Make sure the scene is safe. You cannot help anyone if you become a second victim.
• Check for response. Tap and shout.
• Call 911 and get an AED. Put your phone on speaker so the dispatcher can coach you.
• Position the person. Lay them flat on their back on a firm surface.
• Place your hands. Put the heel of one hand on the center of the chest, on the lower half of the breastbone. Put your other hand on top and lace your fingers together.
• Push hard and fast. Straighten your arms, position your shoulders over your hands, and push at least 2 inches deep at 100 to 120 compressions per minute.
• Let the chest come all the way back up between compressions. Do not lean on the chest.
• Give rescue breaths if trained. After 30 compressions, give 2 breaths, each about 1 second long, watching for the chest to rise.
• Use the AED as soon as it arrives. Turn it on and follow its spoken prompts.
• Keep going until the person shows signs of life, emergency responders take over, or you are too exhausted to continue.

If you are not trained in rescue breaths, or are unwilling to give them, do hands-only CPR. Push continuously at the same rate and depth without stopping for breaths. For an adult who collapses suddenly, hands-only CPR is a reasonable choice, and dispatchers commonly coach callers through it.

How Hard and How Fast Should Chest Compressions Be?

Compressions are the part of CPR that keeps blood moving, so depth and rate matter more than almost anything else you do. Push at least 2 inches deep and aim for 100 to 120 compressions per minute.

That rate is roughly the beat of the disco song “Stayin’ Alive,” which is why CPR instructors use it. Going faster than 120 tends to reduce depth. Going slower than 100 means less blood flow. Both are common in real emergencies, especially as the person doing CPR gets tired.

Two habits quietly undercut compressions. The first is leaning on the chest between pushes, which prevents the chest from refilling with blood. The second is stopping too often. Every pause in compressions drops blood pressure, and it takes several compressions to build it back up. Keep interruptions to under 10 seconds when you can, and swap with another rescuer every couple of minutes if one is available.

Push on the center of the chest, on the lower half of the breastbone. Pushing too low, over the tip of the breastbone, raises the risk of injury to internal organs without helping circulation.

Should You Give Rescue Breaths?

Rescue breaths add oxygen to the blood, but for adults who collapse suddenly, the blood is usually still well oxygenated in the first minutes. That is why hands-only CPR works reasonably well in that situation.

Rescue breaths matter more when the cause was a lack of oxygen to begin with, such as drowning, choking, or a drug overdose. In those cases, breaths plus compressions are the better approach if you are trained.

The standard ratio for one or two rescuers trained in CPR is 30 compressions to 2 breaths. Each breath should last about 1 second and make the chest rise. Do not blow hard or fast. Overinflating pushes air into the stomach, which can cause vomiting.

If you have a barrier device or pocket mask, use it. If you do not and you are unwilling to give mouth-to-mouth, hands-only CPR is far better than doing nothing.

How Do You Use an AED During CPR?

An AED is a portable device that checks the heart’s rhythm and delivers a shock if a shockable rhythm is present. Using one early gives the best chance of survival for many cardiac arrest victims.

Turn the AED on and follow its voice prompts. It will tell you to attach the pads to the person’s bare chest. Most adult pads go on the upper right chest and the lower left side. Dry the chest if it is wet, and remove any medication patch under the pads.

During analysis and any shock, no one should touch the person. The AED will prompt you to stand clear. After the shock, or if no shock is advised, resume compressions right away. Do not wait to check for a pulse. The AED will reanalyze the rhythm every couple of minutes and tell you if another shock is needed.

Do not delay compressions to go find an AED. Send someone else. If you are alone and the AED is nearby, get it, but keep the interruption brief.

What Mistakes Reduce the Chances of Survival?

The biggest mistake is hesitation. People freeze because they are afraid of doing it wrong or causing harm. CPR performed imperfectly is far better than CPR not performed at all.

Other common errors include:

• Pushing too shallow. Compressions under 2 inches move less blood.
• Pushing too fast. Racing past 120 per minute usually means shallower pushes.
• Leaning on the chest. This prevents the heart from refilling between compressions.
• Long pauses. Stopping to check for a pulse, reposition, or talk costs circulation.
• Waiting for gasps to stop. Agonal gasps are not breathing, and waiting wastes time.
• Not calling 911 first. Dispatchers can coach you through CPR while help is on the way.

One point worth knowing: broken ribs are a real risk of CPR, and that is acceptable. Rib fractures heal. A heart that has stopped does not restart without circulation. If you feel or hear a crack, keep going.

Can CPR Be Learned Without a Class?

You can learn the basics from videos and dispatcher coaching, but a hands-on class is better. CPR classes let you practice on a manikin and get feedback on depth and rate, which is hard to judge on your own.

Many communities offer CPR and first aid courses through hospitals, fire departments, and the American Red Cross. Some are free or low cost. The American Heart Association also offers online and blended courses. A class takes a few hours and can be repeated every couple of years to keep skills sharp.

Even if you never take a class, knowing the sequence — call 911, push hard and fast in the center of the chest, use an AED if one is available — gives you a real chance to help. The person on the ground has no better option than a bystander willing to act.