Getting started

When doing CPR, focus on giving chest compressions. Add rescue breathing only if you’re trained in CPR and are comfortable doing rescue breathing. Research has found that when done correctly, chest compressions alone work just as well.

The steps

Always make sure the scene is safe.

Step 1.  Check the person and start the emergency response system

• Tap or gently shake the person if they collapse. In a loud voice ask, “Are you OK?”

• If the person responds, stay with them. Call 911. Keep the person comfortable and warm until emergency rescuers arrive­.

• If the person does not respond, is not breathing, or is gasping, shout for help and call 911 right away.

• If you know an AED is available right away, get it quickly and put it near the person. If an AED is not close by, start compressions.

• If other people are with you, have one of them call 911. Someone should also try to find an AED, if available. In the meantime, you should start chest compressions right away.

Step 2. Start chest compressions

• Lay the person on their back on a firm surface.

• Kneel next to the person.

• Locate where to place your hands: Imagine a line that runs between the person’s nipples.

• Place the heel of one hand on the breastbone just below the imaginary line. Place your other hand on top of the first hand. Lift your fingers so that just the heels of your hands are doing the work.

• Position your shoulders over your hands. Keep your shoulders, elbows, and hands aligned. Use your body weight to help you push straight down. Keep your elbows locked.

• Compress the chest to a depth of at least 2 inches but no more than 2.4 inches. Don’t be alarmed if you hear and feel popping and snapping. The person’s bones and cartilage are moving from the weight of your compressions.

• Allow the person’s chest to come back up after each compression. This allows the heart to refill with blood. Don’t take your hands away from the person’s chest. Keep the heels of your hands in place during compressions.

• Give 30 compressions. Push hard, push fast (at a rate of at least 100 to 120 compressions per minute).

• If you’re trained in CPR and can do rescue breaths, now is the time to do so (see step 3). Continue with the cycle of 30 compressions and 2 rescue breaths until help arrives or the person breathes, coughs, or moves.

• If you don't know how or prefer not to give rescue breaths, continue doing compressions until the person shows signs of movement, the AED is on hand (see step 4), or emergency rescuers take over.

Step 3. Start rescue breathing

• You can use a protective face mask during rescue breathing. Follow the instructions that come with the mask.

• Put one hand on the person’s forehead. With your other hand, put 2 fingers under the person’s chin and tilt the head upward. This keeps the airway open.

• Take a normal breath (not a deep breath). Pinch the person’s nose shut. Place your mouth over the person’s open mouth.

• Give one slow breath. The breath should last 1 second (in your mind, count “one one-thousand”).

• Check to see if the person’s chest rises:

  • If the chest rises, air has gone into the lungs. Let the person exhale. If the person responds by breathing, coughing, or moving, don't give any more chest compressions. Keep the person comfortable and warm until help arrives.

  • If the chest does not rise, air has not entered the person’s lungs. The airway may be blocked. Remove your mouth from the person’s mouth, and tilt the person’s head again.

  • Give another slow breath.

  • If the person’s chest still does not rise, start giving chest compressions again.

Continue with the cycle of 30 compressions and 2 rescue breaths until the person shows signs of movement, the AED is on hand (see step 4), or emergency rescuers take over.

Step 4. Using the AED

• Make sure you are in a dry area. If not, move the person to a dry area with a firm surface.

• Remove the person’s clothing from their upper body. If needed, dry the person's chest.

• Turn on the AED. Listen to and follow the instructions:

  • Don't touch the person while the AED checks the person’s heart rhythm.

  • The AED will deliver a shock if needed. Some AEDs will tell you to press a button to deliver the shock.

  • Put the pads on the person’s chest. Follow the pictures on the instructions that come with the AED.

  • Start chest compressions and rescue breathing again. Don't remove the chest pads. The AED will continue to check the person’s heart rhythm.

• If the person responds, stay with them. Keep the person comfortable and warm until help arrives.

Continue CPR with the instructions from the AED. Do this until the person responds or help arrives.