Hands-Only CPR: Help Until Help Arrives

When an adult's heart suddenly stops, the blood stops moving. Chest compressions keep some blood flowing to the brain until trained help arrives. The American Heart Association says immediate CPR can double or triple a person's chance of surviving a cardiac arrest.

Hands-only CPR means CPR without rescue breaths. It is recommended for bystanders who see a teenager or adult suddenly collapse outside hospital, at home, at work or in a public place. The NHS also advises that if you are not completely confident giving rescue breaths, you should do hands-only CPR instead.

How to do hands-only CPR

1. Check the person. Tap or shake their shoulder and ask loudly, "Are you OK?" Look to see whether they are breathing normally.
2. Call for help. If they are unconscious and not breathing normally, call Rescue 1122 where available, or arrange immediate transport to the nearest hospital emergency department. Send someone else to make the call if you can, so you can start pushing. The NHS notes that emergency call handlers can talk you through basic life-saving steps on the phone.
3. Position your hands. Place the heel of one hand on the breastbone in the centre of the chest. Place your other palm on top and interlock your fingers.
4. Get your body over the chest. Keep your arms straight and your shoulders directly above your hands.
5. Push hard and fast. Press down 5 to 6 cm (about 2 to 2.5 inches). The American Heart Association describes the target as at least 5 cm and no more than 6 cm for an average adult.
6. Keep the rhythm. Aim for 100 to 120 pushes a minute.
7. Let the chest come back up fully after each push, without taking your hands off the chest.
8. Do not stop. Keep going until the person moves or responds, until the ambulance team takes over, or for as long as you physically can.

If a defibrillator (AED) is nearby

Send someone to fetch it while you keep pushing. Turn the machine on, and it will tell you what to do. Follow its spoken instructions, then start or restart chest compressions as directed.

If you are fully trained and confident

The NHS says trained rescuers who are confident in their skills can give chest compressions with rescue breaths: 2 rescue breaths after every 30 compressions, keeping the same compression rate of 100 to 120 a minute. If there is any doubt, stick to compressions only.

What NOT to do

• Do not wait until you feel sure. Doing nothing is worse than imperfect compressions. Call for help and start pushing.
• Do not attempt rescue breaths if you are not confident. The NHS advises hands-only CPR instead.
• Do not push shallowly. Gentle pushes do not move blood. Push hard.
• Do not push deeper than about 6 cm in an average adult.
• Do not lean on the chest between pushes. Let it spring all the way back each time.
• Do not start compressions on someone who is breathing normally. Hands-only CPR is for a person who is unconscious and not breathing normally.
• Do not stop to keep rechecking once you have started, unless the person clearly responds or help takes over.

When to get emergency help

Call Rescue 1122 where available, or go to the nearest hospital emergency department, immediately if a person:

• Suddenly collapses and does not respond when you shake them and shout
• Is not breathing, or is only making occasional gasping noises
• Has no normal breathing after a drowning, electric shock, choking or collapse
• Recovers after CPR, as they still need urgent hospital assessment

Make the call first or have someone else make it while you start compressions. Every minute without blood flow matters.

The best preparation is a short hands-on CPR class. Practising on a manikin once makes it far easier to act if the moment ever comes.