CPR Essentials: Why Chest Compressions Come First and How to Perform Them

Why Chest Compressions Come First

In cardiac arrest, the heart stops pumping effectively. Immediate chest compressions manually circulate blood, delivering residual oxygen to the brain and heart. Every minute of delay reduces survival by 7–10%.

High‑Quality CPR Steps (Adult, Lay Rescuer)

1. Ensure scene safety.
2. Check responsiveness: Tap and shout, "Are you okay?"
3. Call 911 / activate emergency response (or send someone). Get AED if available.
4. Check breathing: Scan chest for 5–10 sec. Absent or only gasping = cardiac arrest.
5. Begin compressions:
   • Position: Heel of one hand on lower half of sternum (center of chest), other hand on top, fingers interlaced.
   • Body mechanics: Shoulders over hands, arms straight, use body weight.
   • Depth: ≥2 inches (5 cm), avoid >2.4 inches (6 cm).
   • Rate: 100–120 compressions/minute.
   • Recoil: Allow full chest recoil — don't lean.
   • Minimize interruptions: <10 seconds for breaths, AED analysis, shock.
6. After 30 compressions: Give 2 rescue breaths (if trained/willing) — each over 1 sec, visible chest rise. If untrained or unwilling: continue compression‑only CPR.
7. Attach AED ASAP: Follow prompts. Resume compressions immediately after shock/no‑shock.
8. Continue until: EMS takes over, AED analyzes, person moves/breathes normally, or you are exhausted.

Key Performance Metrics

• Chest compression fraction (CCF): >80% of resuscitation time.
• Depth, rate, recoil as above.
• Ventilation: 10 breaths/min if advanced airway; 30:2 if not.

Special Situations

• Children/infants: 15:2 ratio (2 rescuers); 1/3 AP depth; 2‑thumb encircling (infant) or heel of 1 hand (small child).
• Pregnancy: Manual left uterine displacement during compressions.
• Opioid overdose: Naloxone + CPR if unresponsive.

Remember

Push hard, push fast, don't stop. Your compressions are the heart's backup pump.