According to the British Heart Foundation, around 60,000 cardiac arrests occur out of hospital in the UK every year. However, survival rates after a cardiac arrest remain very low, averaging between 2 and 12%. Bystander CPR can make a significant difference to whether someone survives or not, as this action restores the circulating blood flow, supplying the vital organs with oxygen. Learning how to perform adult CPR is therefore an essential skill to have. Although there is no substitute to attending a CPR course, the basics of adult CPR are covered here, providing you with the key points needed to deliver CPR in an emergency.

Before Delivering Adult CPR

Following the Resuscitation Council (UK) guidelines, if you find someone collapsed, you should first make sure that you, the victim and anyone else at the scene is safe. Your next priority is to check whether the victim is conscious by gently shaking their shoulders and asking if they are alright. Without a response you should then shout out for help if no one else is around and place the victim on their back to open their airway. This is simple to do by gently tilting their head back with your hand on their forehead and lifting their chin using your fingers. With their airway open, it is time to look for movement in their chest, listen out for breath sounds and see whether you can feel their breath on the skin of your cheek. If you don’t think the person is breathing or their breaths are limited, get someone to phone for an ambulance or use your own mobile if there is no one else around. It is now time to start adult CPR.

Delivering Adult CPR

To perform CPR on an adult, you need to combine chest compressions and rescue breaths. If you are unfamiliar with how to give chest compressions, follow this step-by-step guide:

  • Kneel at the victim’s side and put the heel of your hand on the centre of their chest, located in the lower section of their breastbone.
  • Put the heel of your free hand above your first hand and interlock your fingers.
  • Place yourself over their chest and using straight arms, press down into their breastbone to a depth of 5 to 6cm. However, you shouldn’t put pressure on the end of their breastbone or lower abdomen.
  • Following each compression, allow the release of pressure without your hands moving away from their breastbone. The release of pressure should take as long as when you apply pressure.
  • You should complete between 100 and 120 compressions per minute.

After 30 compressions, the next stage of adult CPR is giving the rescue breaths as follows:

  • Pinch the victim’s nose shut and let their mouth open while you maintain their head tilted and chin lifted.
  • Breathe in normally and put your lips around theirs, ensuring there is a good seal before blowing into their mouth. Within a second you should see their chest rise normally and then when you remove your mouth, the chest falls and the air escapes. In case the chest fails to raise, check there is no obstruction in their airway and that you have enough of a head tilt and chin lift.
  • Repeat the above to give a second rescue breath. You should complete both rescue breaths within 5 seconds.

After delivering 2 rescue breaths, resume 30 compressions and complete this procedure throughout giving adult CPR. You should only stop CPR when the victim regains consciousness and begins to breathe normally again, or medical help is ready to take over. However, if there are other people at the scene, you can take it in turns to provide CPR every couple of minutes to prevent fatigue, though obviously disruption of CPR must be kept to a minimum during these change overs.

Compression-only Adult CPR

Although ideally you will perform both compressions and rescue breaths during CPR, if you have not received CPR training or you do not wish to use rescue breaths, it is possible to deliver adult CPR giving only the chest compressions and this is certainly far better than taking no action at all. When you opt to do this, you should deliver compressions continuously at 100 to 120 per minute, again only stopping if the victim recovers both consciousness and breathing, or trained help arrives to provide support.
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