How to Perform CPR: A Guide to Cardiopulmonary Resuscitation

CPR, short for cardiopulmonary resuscitation, is a lifesaving procedure to help increase the chance of someone’s survival after cardiac arrest. Cardiac arrest happens when a person’s heart stops beating and thus stops pumping blood throughout the body. The person stops breathing or gasps for air, and they become suddenly unconscious.

Cardiac arrest can be caused by several types of heart problems, including:

— Abnormal heart rhythms, such as ventricular tachycardia.

Cardiomyopathy, which is a disease of the heart muscle that affects the heart’s ability to pump blood throughout the body.

— Scarring of the heart tissue.

The use of certain recreational drugs, such as cocaine, also can cause cardiac arrest in people who are otherwise healthy.

Cardiac arrest also is different from a heart attack. A person having a heart attack is usually awake and alert and will experience symptoms such as chest pain or pressure, extreme fatigue, and what feels like indigestion, says Dr. Matthew Levy, an associate professor of emergency medicine at Johns Hopkins University School of Medicine and an emergency medicine physician at Johns Hopkins Hospital in Baltimore.

[See: 6 Signs You’re Having a Heart Attack.]

How CPR Improves Survival

More than 356,000 cardiac arrests happen outside of hospitals in the U.S. each year, according to the Sudden Cardiac Arrest Foundation, and about 70% of those take place in the home, says Dr. David Markenson, co-chair of the American Red Cross Scientific Advisory Council and director and medical director of the Center for Disaster Medicine at New York Medical College. About nine of every 10 people who have a cardiac arrest outside of a hospital don’t survive.

For every minute that someone is in cardiac arrest, Levy adds, the chance of survival goes down 10%. So, by 10 minutes, the survival rate is down to zero. CPR provides the circulation of oxygenated blood to the body when the heart can’t pump on its own, so knowing it, Markenson says, can be an important way to help save someone’s life. When CPR is performed immediately after cardiac arrest occurs, it can double or triple the chance of survival, he adds.

For many years, CPR was taught with rescue breathing, also called mouth-to-mouth. Although that approach still is part of CPR taught mostly to health professionals, health experts now focus more on hands-only CPR with the general public. This type of CPR consists of using your hands to make fast, constant chest compressions until more help arrives.

Hands-only CPR doesn’t include rescue breaths, adds Dr. Marc Helzer, a primary care physician specializing in family medicine at University of Michigan Health-West in Rockford, Michigan. Instructors teach hands-only CPR because of the greater effectiveness of chest compressions and to encourage more bystanders to perform CPR, rather than avoid it for fear of disease transmission from rescue breathing.

[SEE: The Best Heart-Healthy Snacks.]

Protections for Bystanders Who Perform CPR

There may be a couple of reasons why someone would hesitate to perform CPR, including worries over breaching physical boundaries or causing more injuries to a person experiencing cardiac arrest.

In a 2020 study in the journal Circulation, researchers determined that among more than 4,800 resuscitated patients, 55% of men and 49% of women had bystander CPR. The lower CPR rate for women is thought to be due to fear over inappropriate touching, explains Dr. Dianne Atkins, a volunteer expert for the American Heart Association, or AHA, and chair of the AHA’s Emergency Cardiovascular Care Committee, based in Iowa City, Iowa.

However, Good Samaritan laws protect bystanders who are acting with genuine intentions to help someone, Atkins says. Good Samaritan laws aim to protect bystanders who help someone in distress from getting sued in case the injured person experiences further injury or death.

Some people learning CPR also fret over breaking a rib if they perform CPR too forcefully. Yet ribs can heal, making that a more desirable outcome if it happens versus not surviving cardiac arrest, Levy says.

“Don’t be afraid to help,” Helzer advises. “Learn more about CPR so you can be more confident.”

[SEE: Signs of a Bad Heart: Don’t Overlook These Cardiac Symptoms.]

How to Perform CPR

Classes are the most effective way to learn CPR. However, anything you can learn about CPR basics could help save someone.

Here’s what to do if you’re in a situation where someone may need CPR:

— If you see someone suddenly collapse, tap on their shoulders and shout, “Are you OK?”

— Assess your surroundings.

— Have someone call 9-1-1 for you.

— Sit to the side of the person who’s collapsed.

— Begin performing fast, firm chest compressions, pushing down at least two inches.

If you see someone suddenly collapse, tap on their shoulders and shout, “Are you OK?”

Look at the body, including the chest area, for normal breathing. This step should take no more than five to 10 seconds. If they aren’t breathing or are gasping for air, plan to proceed with CPR after quickly following steps 2 and 3.

Assess your surroundings.

Check to make sure that you’re in a safe area to perform CPR and that you’re not facing danger from cars, chemicals or something else that could hurt you.

Have someone call 9-1-1 for you.

If you’re not alone, don’t be afraid to take the lead. Although it’s normal to feel less confident of yourself or nervous about telling others what to do, you may save a life with your actions. If you don’t know the names of those around you, use identifiers: “You, in the red shirt. Call 9-1-1!” or “You, in the yellow sweater. Find out if there’s a defibrillator here.”

If you’re alone, call 9-1-1 and put it on speakerphone mode beside you. The 9-1-1 dispatcher also may be able to walk you through what you need to do to respond.

Sit to the side of the person who’s collapsed.

Place the heel of one hand on the center of their chest. Next, put the heel of your second hand on top of your first hand, with fingers interlocked.

Begin performing fast, firm chest compressions, pushing down at least two inches.

Chest compressions can help provide blood to the whole body and oxygen to the brain. The songs “Staying Alive” by the Bee Gees and “Crazy in Love” by Beyoncé both have the rhythm of 100 to 120 beats a minute, which is the right rhythm you need for the chest compressions, Atkins says. Let the chest rise completely before you push down again. Continue performing chest compressions until professional emergency help has arrived or until the person you’re helping is breathing again.

Additional Guidelines

The American Red Cross uses the phrase Check, Call, Care, which uses many of the steps above, to remember what to do in a situation needing CPR or other first-aid care, Markenson says.

If you are in a public area such as a mall, store or school, you can also ask someone to look for an automatic external defibrillator device, or AED, which provides a shock to the heart for someone in cardiac arrest. Although many AEDs have audio-guided prompts on how to use them, they also are critical to have close for first responders if you’re not able to use one yourself.

In children, the hands-only technique is similar to what you use in adults. However, for a small child, you would only use one hand to perform chest compressions. In a baby, you would use your two thumbs and cradle the rest of your hands around the baby’s chest to provide support.

Children also should receive rescue breathing, but if you don’t know how to do that or can’t, then chest compressions should still be used, Atkins says.

CPR Classes and Resources

CPR classes are available in person, online or as a combination of the two. You may want to take an online CPR class followed by in-person instruction. These classes allow you to practice CPR so you can get instructor feedback and learn how to perform it more confidently and accurately.

Classes also can provide CPR certification, which some people may require for their jobs. In-person classes are a good choice if you prefer traditional classroom learning, Helzer adds.

If you don’t have time to take in-person CPR classes, online-only classes are a good alternative.

CPR classes are usually low cost, shouldn’t be hard to find in most areas and brief. “You can learn CPR and first aid in less than half a day,” Markenson says. Classes geared toward health professionals will last longer and go into more detail about performing CPR with rescue breathing, as well as other first aid.

If you aren’t able to take classes, then even just watching CPR videos is helpful.

Here are resources to broaden your knowledge of how to perform CPR, including some short videos on how to perform hands-only CPR:

— Two short videos from the AHA on how to perform hands-only CPR.

— A list of the AHA’s CPR and first aid training classes.

— American Red Cross classes for CPR and first aid.

— An American Red Cross short video on performing hands-only CPR.

— The American Red Cross First Aid app, which is free and provides information on handling various first aid situations, including CPR.

— Cincinnati Children’s two-minute video on performing CPR on children.

More from U.S. News

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How to Perform CPR: A Guide to Cardiopulmonary Resuscitation originally appeared on usnews.com

Update 12/06/22: This story was previously published at an earlier date and has been updated with new information.

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