CPR Guide

EMERGENCY

REMEMBER: C-A-B
Compressions first - push hard and fast
Airway - tilt head, lift chin
Breathing - 2 rescue breaths after 30 compressions

When to Start CPR

Person unresponsive - not moving, not responding to voice or touch
Not breathing OR only gasping (agonal breathing - irregular, reflexive)
No pulse detected (if trained to check - don't delay compressions searching)

If person is breathing normally and has pulse, put in recovery position (on side), monitor, call for help.

Before Starting

Check scene safety - don't become a second victim
Check responsiveness - tap shoulders, shout "Are you okay?"
Call for help - point at someone specific: "YOU, call 911, get an AED"
If alone: Call 911 first (put on speaker), then start CPR

Adult CPR (8+ years)

Compressions

Place person on firm, flat surface
Kneel beside their chest
Place heel of one hand on center of chest (nipple line)
Place other hand on top, interlock fingers
Position yourself directly over chest, arms straight
Push HARD - at least 2 inches (5 cm) deep
Push FAST - 100-120 beats per minute
Allow full chest recoil between compressions (don't lean on chest)
Count out loud: "One, two, three..." to maintain rhythm

Ratio: 30 compressions : 2 breaths

Harder than you think. You will hear/feel ribs possibly breaking. Continue. Broken ribs are survivable; cardiac arrest is not.

Airway & Breaths

After 30 compressions, place one hand on forehead, tilt head back
Place two fingers under chin, lift jaw forward
Look in mouth - if visible object, remove with finger sweep
Pinch nose closed with hand on forehead
Take normal breath, seal your mouth over theirs
Give 1 breath over 1 second - watch chest rise
Allow chest to fall, give second breath
Immediately resume compressions

If chest doesn't rise: reposition head, try again. If still no rise after 2 attempts, skip breaths and continue compressions. Don't interrupt compressions for more than 10 seconds.

Child CPR (1-8 years)

Same 30:2 ratio
Use one or two hands depending on child size - compress 2 inches
Less force than adult but still deep enough
If alone: do 2 minutes of CPR BEFORE calling 911 (children usually have respiratory cause)
Breaths: smaller volume - just enough to see chest rise

Infant CPR (under 1 year)

Use 2 fingers in center of chest, just below nipple line
Compress 1.5 inches (4 cm) - about 1/3 chest depth
Rate still 100-120/min
Ratio: 30:2 for one rescuer, 15:2 for two rescuers
Breaths: use your mouth over infant's nose AND mouth, or just nose
Use gentle puffs from your cheeks, not full breaths

Hands-Only CPR

If untrained, uncomfortable with breaths, or situation where breaths aren't feasible:

Continuous compressions at 100-120/min
No pauses for breaths
Continue until help arrives, AED available, or person wakes up

Hands-only CPR is effective for most adult cardiac arrests. Doing SOMETHING is better than doing nothing. Push hard, push fast, don't stop.

COMPRESSION RHYTHM - 100-120 BPM
Stayin' Alive (Bee Gees) | Crazy in Love (Beyonce) | Hips Don't Lie (Shakira)
Another One Bites the Dust (Queen) - ironic but works

AED Use (Automated External Defibrillator)

Turn on AED - follow voice prompts
Attach pads to bare chest as shown in pictures on pads
Don't touch patient during analysis
If shock advised: clear patient, press shock button
Immediately resume CPR after shock (or if no shock advised)
Continue until AED reanalyzes or help arrives

Source: AEDs in public buildings, airports, gyms. Locations often marked with AED sign. Apps like PulsePoint show nearest AED.

DIY: No substitute for AED. CPR alone rarely restarts heart - maintains blood flow to brain until defibrillation available. In wilderness/amputation scenarios, continue CPR until exhaustion or help arrives.

AEDs are designed for untrained users. They will NOT shock if not appropriate. Voice prompts guide everything. Pads have pictures. Don't let fear stop you.

Special Situations

Drowning

Start with 2 rescue breaths BEFORE compressions (drowning is respiratory arrest first). Continue normal CPR after initial breaths. Remove from water if safe, but begin breaths immediately if possible.

Opioid Overdose

Give naloxone (Narcan) if available - nasal spray or injection. CPR if not breathing. Naloxone wears off in 30-90 min - person may stop breathing again. Always call 911 even if they wake up.

Source: Naloxone available at pharmacies without prescription in most states. Harm reduction programs give free kits. Carry it if you know opioid users.

Electrocution

DO NOT TOUCH person if still in contact with electrical source. Turn off power or separate with non-conductive material (dry wood, rubber). Then assess and begin CPR if needed.

Trauma

If cardiac arrest from trauma (car crash, gunshot, fall): CPR unlikely to help but attempt if safe and resources allow. Control massive bleeding first. Address reversible causes if possible.

Pregnancy

Same CPR technique. Place hands slightly higher on sternum as uterus pushes diaphragm up. If possible, tilt woman 15-30 degrees to left (place towel/pillow under right hip) to reduce pressure on vena cava. Perform emergency C-section if prolonged arrest and fetus viable (advanced - paramedic/physician).

Hypothermia

Check pulse for 60 seconds - cold heart may beat very slowly. If no pulse after 60 seconds, begin CPR. Handle gently - cold heart is irritable. Continue CPR until person is warm. "Not dead until warm and dead."

When to Stop CPR

AED or EMS takes over
Person shows signs of life (breathing, movement)
Scene becomes unsafe
You are too exhausted to continue
Another trained rescuer takes over

In wilderness scenarios: Continue until exhaustion if evacuation possible. Consider stopping after 30+ minutes of no ROSC (return of spontaneous circulation) in unwitnessed arrest with no reversible cause.

After CPR

If person regains pulse/breathing:

Place in recovery position (on side, top leg bent, arm supporting head)
Monitor breathing continuously
Keep warm
Don't give food or water
Stay until EMS arrives

Training

Reading is not enough. Take a class.

Source: Red Cross CPR/AED classes ($70-100). American Heart Association HeartSaver ($50-80). Fire departments often offer free/cheap community classes. Online-only certifications are often not accepted - need hands-on practice.

DIY: YouTube has demonstration videos but cannot replace hands-on practice with mannequin. Practice hand positioning and depth on a firm pillow. Understand the concepts even if you can't get certified.

KEY POINTS:
Push HARD (2+ inches) and FAST (100-120/min)
Minimize interruptions - keep blood flowing
Don't stop until help arrives or person wakes up
Do SOMETHING - inaction guarantees death

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