CPR for Adults: Checking Responsiveness, Chest Compressions, and Rescue Breaths

Tap the person's shoulders firmly and shout "Are you okay?" Look for any response—eye movement, groaning, or movement. Check their breathing for no more than 10 seconds. Look for chest rise, listen for breath sounds, feel for air movement. Do not delay if breathing is absent or only gasping—proceed immediately to step 2.

Gasping is not normal breathing. Treat it as cardiac arrest and start CPR immediately.

Shout for help immediately. If alone and have phone access, call emergency services (911, 999, or local equivalent) or have someone else do it. If alone and no phone, send someone to find an AED while you start CPR. If a defibrillator is available, retrieve it or ask someone to bring it. Do not leave the person to search for help unless directed by emergency services.

Call for help BEFORE or IMMEDIATELY AFTER starting compressions. Do not delay CPR to search for a phone.

Place the person flat on their back on a firm surface. If on a bed, move them to the floor. Tilt their head back slightly to open the airway. Remove any obvious obstructions from the mouth (dentures, food, debris). If you suspect spinal injury, avoid tilting the head—use jaw thrust instead by lifting the jaw forward without moving the neck.

Locate the center of the chest between the nipples. Place the heel of one hand on the sternum at this location. Place your other hand on top, interlacing fingers. Keep your arms straight and position shoulders directly above hands. Your body weight should drive compressions downward, not your arm muscles alone.

Press hard and fast at least 2 inches (5 cm) deep—compress at least one-third of the chest depth. Compress at a rate of 100-120 compressions per minute (about the tempo of the song "Stayin' Alive"). Let the chest recoil completely after each compression. Do not lean on the chest between compressions. Continue without stopping until help arrives, an AED is ready, or you are exhausted.

Compression depth is critical—30% of adults receive insufficient depth compressions. Push hard enough to feel resistance.

After 30 compressions, give 2 rescue breaths if trained and willing. Tilt the head back, pinch the nose closed, and seal your mouth over theirs. Blow steadily for 1 second, watching for chest rise. If the chest does not rise, reposition the head and try again. Immediately resume compressions at a 30:2 ratio (30 compressions, then 2 breaths). If unwilling or unable to give breaths, compression-only CPR is effective—continue compressions without stopping.

Rescue breaths require training and willingness. Compression-only CPR is equally effective for adults and safer if you're untrained or uncomfortable with mouth-to-mouth contact.

When the AED arrives, turn it on immediately. Follow voice prompts—they will guide you through pad placement and analysis. Peel off the chest and attach pads according to the diagram on the pads: one on the right upper chest, one on the lower left ribs. Let the AED analyze the rhythm. If it says "Shock advised," ensure no one is touching the person, press the shock button, then resume CPR immediately. If "No shock advised," continue CPR without stopping.

Do not delay CPR to find an AED. If no AED is immediately available, start CPR at once.

Continue CPR until: (1) help arrives and takes over, (2) the person starts breathing and responding, (3) an AED is used and the person regains consciousness, or (4) you are physically unable to continue. Do not stop CPR early—continue pushing hard and fast. If the person vomits, turn their head to the side and clear the mouth, then resume compressions immediately.

Do not declare someone dead. Only emergency personnel can do this. Continue CPR until told to stop by emergency services or you cannot physically continue.