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Cardiac arrest - out of hospital care - Management
How do I perform cardiopulmonary resuscitation?

  • Start chest compressions:
    • Kneel by the side of the person.
    • Place the heel of one hand in the centre of the person's chest.
    • Place the heel of your other hand on top of the first hand.
    • Interlock the fingers of your hands and ensure that pressure is not applied over the person's ribs. Do not apply any pressure over the upper abdomen or the bottom end of the bony sternum (breastbone).
    • Position yourself vertically above the person's chest and, with your arms straight, press the sternum down by 5–6 cm.
    • After each compression, release all the pressure on the chest without losing contact between your hands and the sternum.
    • Repeat at a rate of 100–120 times a minute (about two compressions a second).
    • Compression and release should take an equal amount of time.
    • If a crack is heard or felt during compressions (indicating a fracture to the costal cartilage or ribs) continue with chest compressions, having checked that your hands are in the correct position.
  • Combine chest compressions with rescue breaths:
    • After 30 chest compressions, open the airway again:
      • Place your hand on the person's forehead and gently tilt their head back.
      • With your fingertips under the point of the person's chin, lift the chin to open the airway.
    • Pinch the soft part of the person's nose closed, using the index finger and thumb of the hand on their forehead.
    • Allow their mouth to open, but maintain chin lift.
    • Take a normal breath and place your lips around the mouth, making sure that you have a good seal.
    • Blow steadily into the mouth whilst watching for the chest to rise. Take about 1 second to make the chest rise as in normal breathing; this is an effective rescue breath.
    • Maintaining head tilt and chin lift, take your mouth away and watch for the chest to fall as air comes out.
    • Take another normal breath and blow into the person's mouth once more to give a total of two effective rescue breaths.
    • Without delay, return your hands to the correct position on the sternum and give a further 30 chest compressions.
  • Continue with chest compressions and rescue breaths in a ratio of 30:2.
  • Stop to recheck the person only if they start breathing normally or show other signs of life (such as moving, speaking, opening their eyes); otherwise do not interrupt resuscitation.

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