Cardiopulmonary Resuscitation (CPR)
What is CPR?
Cardiopulmonary resuscitation (CPR) is a way to save the life of someone who is in cardiac arrest. It's a fairly simple technique that anyone can learn. The key part of CPR is chest compressions, which keep blood flowing to vital organs until a regular heartbeat returns. Breaths of oxygen bring more oxygen into the person with cardiac arrest.
Why is CPR used?
A person of any age who collapses, doesn’t respond, isn’t breathing, and has no pulse needs CPR.
With 475,000 people dying each year from cardiac arrest, it’s a leading cause of death in the United States. Of those who have a cardiac arrest outside a hospital, 90% don’t survive. CPR can greatly improve the odds of surviving.
Most often, an electrical problem makes your heart get out of rhythm (arrhythmia) and makes it stop suddenly. Cardiac arrest keeps your body’s vital organs, including your brain, from getting oxygen-rich blood.
With cardiac arrest, time is of the essence. The situation can be fatal within minutes if the person in cardiac arrest doesn’t get treatment. The chance of surviving goes down 7% to 10% for every minute the person’s heart doesn’t beat normally.
More than half of all people who have cardiac arrest outside of a hospital don't get help right away. If a person does get CPR right after they go into cardiac arrest, their chance of survival can double or even triple.
What happens before CPR?
Before starting CPR, follow these steps:
- After ensuring a safe scene, loudly ask the person if they’re OK.
- Call 911 and ask someone nearby to get an automated external defibrillator (AED).
- Tilt the person’s head back while they’re lying on their back.
- Listen for 10 seconds to see if you hear the person breathing.
- Check for a pulse by feeling the side of their neck
- Perform CPR if you don’t hear the person breathing or see their chest going up and down.
What happens during CPR?
There are two different ways to do CPR.
Hands-only CPR steps for those without CPR training
If you’re not trained in CPR but are in a situation where a teen or adult is in cardiac arrest, call 911 and do chest compressions until emergency help arrives. This is called “hands-only CPR.” By distributing oxygen currently in the person’s body, it can help someone in cardiac arrest until someone with CPR training arrives.
- Call 911 if you see someone collapse. The 911 dispatcher can guide you through the steps to take until paramedics arrive.
- Make sure the scene is safe before you start CPR.
- Put one of your hands on top of the other and start pushing hard in the middle of the person’s chest. Use the heel of your hand, or the part just before your wrist. Keep your arms straight.
- Keep pushing on the person’s chest (called doing compressions) 100 to 120 times per minute.
- Make sure you allow the chest to come all the way back up between compressions
It can be easier to remember the CPR compression rate if you follow the beat of these songs:
- “Stayin’ Alive” by the BeeGees.
- “Walk the Line” by Johnny Cash.
- “Crazy in Love” by Beyonce and Jay-Z.
- “Hips Don’t Lie” by Shakira.
Healthcare providers and others who have CPR training give the person two mouth-to-mouth breaths for every 30 compressions. The compression rate is the same as for hands-only CPR: 100 to 120 compressions per minute, with each compression pushing down 2 inches.
How to do CPR
- If the person isn’t breathing, put one of your hands over the other and put them in the middle of the person’s chest (right under the nipples).
- Putting the force of your body weight behind it, push your hands down hard on the person’s chest.
- Do 100 to 120 compressions per minute and push down 2 inches each time.
- Every 30 compressions (about 20 seconds or so), pause compressions to do a rescue breath. Perform the rescue breath as follows:
- Pinch the person’s nose closed while tilting their head back a little and their chin up.
- Close your mouth over theirs and blow a breath into it so their chest goes up. If the person’s chest doesn’t come up, check to see if there’s something in their mouth.
- Give a total of two breaths and go back to doing compressions.
- Keep doing chest compressions and giving breaths in a cycle until the person revives or more help arrives.
- While you are doing CPR, someone should be bringing an AED (automated external defibrillator) to use for help with rescuing the patient.
If you’re doing CPR on a small infant, put one hand on their forehead to keep their head slightly back. Use your other hand to do compressions that go a third or half the depth of their chest. The number of compressions and breaths is the same as for adults.
What happens after CPR?
After first responders take over caring for the person receiving CPR, they’ll get them to a hospital as soon as possible. If the person survives, healthcare providers will look to see if there’s any organ damage from a lack of oxygen. They’ll also figure out the cause of cardiac arrest and provide whatever treatment the person needs. Many people who survive cardiac arrest stay in a coma, but about half wake up.
Risks / Benefits
What are the advantages of CPR?
By keeping blood moving through a person’s body, CPR prevents organ damage in someone who’s in cardiac arrest.
What are the risks or complications of CPR?
When someone’s in cardiac arrest, the risk of CPR is not doing it soon enough. Without CPR, someone in cardiac arrest won’t survive. With CPR, they have a chance to live. CPR comes with risks because of how hard chest compressions have to be to keep blood circulating. It's possible to break ribs and injure organs within the chest during CPR.
Recovery and Outlook
What is the recovery time?
It can take several months for mild issues with memory, learning and concentration to get better in people who survive cardiac arrest and awaken from a comatose state.
When to Call the Doctor
When should I see my healthcare provider?
If someone you know is having a cardiac arrest, call 911 immediately.
After surviving cardiac arrest, you’ll need follow-up appointments with your healthcare provider. The timing of the appointments will vary depending on your condition. Be sure to contact your provider if you aren’t getting better or if you have new symptoms during your recovery.
Frequently Asked Questions
Will CPR break ribs?
Yes, it’s possible that CPR can break a person’s rib. This is possible because you have to push down hard to get blood moving through a person’s body.
What is CPR without mouth to mouth?
“Hands-only” CPR, described above, doesn’t involve mouth-to-mouth resuscitation. It’s still a valuable form of CPR that can help a person’s blood flow until professional emergency help arrives.
AED vs. CPR
Many public places have an automated external defibrillator (AED) for use in emergency situations. Anyone can use an AED, which delivers a life-saving shock to a person in cardiac arrest. When used in the right way, the shock restores a normal heart rhythm. Most AEDs have easy-to-use instructions on them, but a 911 dispatcher can also help you use the AED. AEDs should be used alongside CPR, not instead of CPR.
You should start CPR and ask someone to call 911 and look for an AED.
A note from Cleveland Clinic
Most cardiac arrests that happen outside a hospital happen at home, so you could be helping a relative or friend if you know CPR. Even the “Hands-only” CPR can help a person stay alive until first responders arrive. CPR increases a person’s chance of surviving cardiac arrest, but it’s important to act quickly.
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