CPR Step-by-Step Guide: Adult Basic Life Support (BLS)

High-Quality CPR: 2020 AHA Guidelines

Scene safety first. Check responsiveness: tap and shout, "Are you okay?"

1. Activate Emergency Response

• Call 911 (or local emergency number) and get an AED.
• If alone with adult: call first, then CPR. If unwitnessed child/infant: 2 min CPR first, then call.

2. Check Breathing & Pulse (≤10 seconds)

• Look for chest rise, listen/feel for air.
• Simultaneously check carotid pulse.
• No normal breathing (only gasping) + no pulse → START CPR.

3. Chest Compressions

• Position: Heel of one hand on lower half of sternum; other hand on top, fingers interlaced.
• Depth: ≥2 inches (5 cm), ≤2.4 inches (6 cm).
• Rate: 100–120/min.
• Recoil: Allow full chest recoil; don't lean.
• Ratio: 30 compressions : 2 breaths (single rescuer).
• Minimize interruptions: <10 seconds for breaths, rhythm checks, AED analysis.

4. Rescue Breaths

• Head tilt–chin lift (jaw thrust if trauma suspected).
• Pinch nose, seal mouth, give 1-second breath → visible chest rise.
• Two breaths after each 30 compressions.
• If no chest rise: reposition head, reattempt. Don't overventilate.

5. AED Use

• Power on → attach pads (right upper chest, left lateral ribcage).
• Clear for analysis → if "shock advised," clear again → deliver shock.
• Immediately resume CPR for 2 minutes before reanalysis.

6. Continue Until

• ROSC (return of spontaneous circulation): breathing, movement, pulse.
• Advanced providers take over.
• You are exhausted/unsafe.
• Physician pronounces death.

Special Situations

• Pregnancy: Manual left uterine displacement during compressions.
• Opioid overdose: Naloxone + CPR; consider rescue breathing if pulse present.
• Drowning: 5 initial rescue breaths before compressions.

Training: Hands-on BLS certification (AHA, Red Cross) is essential. Skills decay rapidly—refresh every 2 years.