Essential CPR Techniques for Adults: A 5-Step Guide

Cardiopulmonary resuscitation (CPR) is a basic life saving technique that saves a life during medical emergencies such as heart attack and cardiac arrest. It doubles a person’s chance of survival if they are in this state of emergency by keeping oxygen rich blood flow to the brain and other vital organs until emergency medical treatment restores the normal heart rhythm. However, remembering the CPR steps and administering them correctly is challenging even after training. Performing CPR on adults is a lot of pressure, especially for bystanders who are not medical personnel, as they have to respond fast and effectively.

In this post, we highlighted the top tips to keep in mind if you need to do the steps of CPR for adults in a critical situation. This is a printable guide that you put on your desk or in your bag so that you will always be prepared.

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Tips for Performing CPR on Adults

Performing CPR on adults is a critical skill that save lives in emergencies. Immediate action significantly increase the chances of survival in cases of sudden cardiac arrest (SCA). Here are five essential tips to help you perform CPR effectively:

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1. Attempt to Wake The Victim

Tap the shoulder of the victim and ask if he or she is okay. If the victim is not breathing or just gasping for breath. Sudden cardiac arrest is a leading cause of death worldwide, affecting approximately 356,000 people outside of hospitals in the United States each year.

• Check for Responsiveness: Tap the victim's shoulder and shout, "Are you okay?" to check for a response. If there is no response and the victim is not breathing or only gasping, immediately call 911 or have someone else call.
• Call for Help: If you are alone, call 911 before starting CPR to ensure emergency services are on their way.

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2. Begin Chest Compressions

Perform 30 compressions, counting aloud to maintain rhythm and accuracy. Chest compressions, if performed immediately, double or triple a person’s chance of survival after cardiac arrest

• Proper Hand Position: Kneel beside the victim and place the heel of one hand on the center of the chest (on the lower half of the breastbone). Place your other hand on top, interlocking your fingers.
• Compression Technique: Use your body weight to push straight down on the chest, compressing it at least 2 inches deep.
• Compression Rate: Perform compressions at a rate of 100 to 120 per minute. Allow the chest to fully recoil between compressions to let the heart refill with blood.

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3. Begin Rescue Breathing

Use the head-tilt, chin-lift technique to open the victim’s airway. Place one hand on the forehead and gently tilt the head back while lifting the chin with your other hand. Pinch the victim's nose shut, seal your lips over their mouth, and give two rescue breaths. Each breath should last about one second and cause the chest to rise visibly. Allow the chest to fall before giving the second breath.

If available, use a CPR mask to deliver breaths and protect yourself from direct contact.

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4. Repeat Chest Compressions and Rescue Breathing

Repeat the cycle of 30 chest compressions followed by two rescue breaths consistently to maximize the effectiveness of CPR. This cycle helps to ensure that oxygenated blood is circulated throughout the body, providing vital organs with the necessary oxygen to function and reducing the risk of brain damage. It is crucial to minimize interruptions between compressions and breaths, as even brief pauses decrease the blood flow and reduce the chances of successful resuscitation.

Maintaining a steady rhythm and keeping a focus on the task at hand helps in delivering continuous and effective compressions. Remember, every second counts, so try to transition smoothly from compressions to breaths and back again, ensuring that the victim receives the most benefit from the CPR being performed. This approach maximizes the chances of reviving the victim and sustaining their life until professional medical help arrives.

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5. Use AED if available

If you have access to an AED or Automated External Defibrillator, continue to do CPR until you attach the device to the cardiac arrest victim and turn it on. If you saw the victim collapse, immediately put the Automated External Defibrillator on. If not, attach it after one minute of CPR.

• Apply the AED: Turn on the AED and follow the voice prompts or instructions. Attach the adhesive pads to the victim's bare chest as shown on the AED diagrams.
• Administer Shock if Advised: If the AED advises a shock, ensure no one is touching the victim, then press the shock button. After the shock, resume CPR immediately.
• Continue CPR: If no shock is advised, continue CPR until emergency medical personnel arrive or the victim shows signs of life.

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According to American Heart Association, use hands-only CPR if you are untrained or not certified. It involves uninterrupted chest compressions of 100 to 120 per minute (no rescue breaths) until an Emergency Medical Team arrives. However, Hands-Only CPR is not recommended for adults whose cardiac arrest is caused by drug overdose, near-drowning, or an unwitnessed cardiac arrest.

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Can performing CPR incorrectly cause harm?

Yes, performing CPR incorrectly potentially cause harm, such as rib fractures, damage to internal organs, or other injuries due to excessive force or improper hand placement. However, the risks of harm are generally outweighed by the potential benefits, as CPR is a life-saving during cardiac arrest. Even if CPR is not performed perfectly, it is better than doing nothing because it maintain some blood flow to vital organs until professional help arrives.

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Are there specific legal protections for bystanders performing CPR?

Yes, many countries and states have Good Samaritan laws that provide legal protections for bystanders who perform CPR or other emergency assistance in good faith. These laws are designed to encourage people to help those in need without fear of legal repercussions, as long as they act reasonably and within their level of training. The specific protections and conditions vary by jurisdiction, so it's important to be aware of the local laws where you live.

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Should rescue breaths always accompany chest compressions for all cases?

Rescue breaths do not always need to accompany chest compressions, especially for untrained bystanders or in certain situations.

• Adults: For adults in sudden cardiac arrest, hands-only CPR (chest compressions only) is recommended if the rescuer is untrained or unwilling to perform rescue breaths. This approach is effective in maintaining blood circulation.
• Children and Drowning Victims: For children, infants, and situations involving drowning or drug overdose, conventional CPR with rescue breaths is recommended, as these scenarios often require additional oxygenation.

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Are there differences in CPR technique for different causes of cardiac arrest?

Yes, there are differences in CPR technique depending on the cause and context of cardiac arrest:

• Sudden Cardiac Arrest (SCA): Typically caused by a heart rhythm problem and occurs abruptly. Hands-only CPR is often sufficient until professional help arrives.
• Asphyxial Arrest (Drowning, Suffocation): Oxygen depletion is a primary concern, so CPR with rescue breaths is crucial to provide both circulation and oxygenation.
• Pediatric Arrest: Often related to respiratory issues, so rescue breaths are essential along with chest compressions.

Adjustments in technique are often based on the patient’s age, size, and the underlying cause of the cardiac event. In all cases, performing CPR promptly and calling emergency services is critical.

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When should you not perform CPR on an adult?

Here are five situations where CPR should not be performed on adults:

1. Signs of death – Rigor mortis (stiffening of the body), livor mortis (skin discoloration), or decapitation.
2. Do Not Resuscitate (DNR) orders – If the patient has an active DNR or similar legal directive.
3. Unsafe environment – Performing CPR would put the rescuer at serious risk.
4. Irreversible injury – Severe trauma that is incompatible with life.
5. End-stage illness – Terminal conditions where CPR would not change the outcome and is against the patient’s wishes.

Always follow guidelines and legal obligations in specific cases.

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How does hands-only CPR differ from traditional CPR?

Hands-only CPR focuses solely on chest compressions without rescue breaths. Traditional CPR, on the other hand, combines chest compressions with rescue breaths. Studies show that hands-only CPR is effective for adult victims of sudden cardiac arrest, with survival rates improving by 50-100% when administered quickly. Traditional CPR is still preferred for infants, children, and cases of drowning or drug overdose, where oxygen deprivation is more severe.

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What are the common mistakes made during CPR?

Common mistakes include pressing too lightly during chest compressions (compressions should be at least 2 inches deep for adults), performing compressions too slowly (optimal rate is 100-120 compressions per minute), and pausing compressions too frequently or for too long. Incorrect hand placement, such as compressing the ribs instead of the sternum, and failing to allow the chest to fully recoil between compressions are other frequent errors.

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How long should you perform CPR before medical help arrives?

CPR should be continued until professional help arrives or the person shows signs of life, such as breathing or moving. The American Heart Association recommends uninterrupted chest compressions for as long as it takes for medical professionals to take over, emphasizing the importance of minimizing pauses to ensure a higher survival rate.

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What are the risks of performing CPR incorrectly?

Incorrect CPR technique can result in broken ribs, damage to the lungs or liver, or punctured lungs. However, the benefits of attempting CPR far outweigh the risks, especially in life-threatening situations like cardiac arrest. Proper CPR training significantly reduces the likelihood of causing harm.

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Is CPR different for men and women?

No. CPR technique does not differ between men and women. Chest compressions should be administered at the same depth and rate regardless of gender. Concerns about performing CPR on women, particularly regarding placement of hands due to breast tissue, should not prevent action. Studies indicate that women are less likely to receive bystander CPR, partly due to hesitation or fear of causing injury.

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What should you do if CPR isn't working?

If CPR does not appear to be working, it is crucial to continue performing chest compressions and call for help if not already done. Pausing or stopping CPR reduces the likelihood of survival. An automated external defibrillator (AED) should be used as soon as available to increase the chance of revival.

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How often should you refresh your CPR training?

CPR training should be refreshed every two years, as recommended by the American Heart Association. Studies show that skills and knowledge begin to decline within three to six months after initial training, making regular CPR refresher courses essential for maintaining effectiveness.

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Are You Ready to Do CPR?

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Sources:

• American Heart Association "CPR Facts and Stats"
• Sudden Cardiac Arrest Foundation.
• National Heart, Lung, and Blood Institute: CPR: How It Can Save Lives
• McNally, B., Robb, R., Mehta, M., et al. (2011). "Out-of-Hospital Cardiac Arrest Surveillance — Cardiac Arrest Registry to Enhance Survival (CARES), 2005-2010." Morbidity and Mortality Weekly Report, 60(8), 1-12.
• Sayre, M. R., et al. (2008). "Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Circulation, 118(5), 257-267. DOI: 10.1161/CIRCULATIONAHA.108.190925

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