Cardiopulmonary resuscitation, commonly known as CPR, is a lifesaving technique crucial in emergencies such as a heart attack or near drowning, where someone’s breathing or heartbeat has stopped. It’s a procedure that combines rescue breathing, which provides oxygen to the person’s lungs, and chest compressions, which keep the person’s blood circulating. Bystander CPR and use of a defibrillator can increase a cardiac arrest victim’s chance of survival by two to four times.
Performing CPR on an adult involves assessing the situation, calling 999 the moment you find someone unresponsive, and delivering chest compressions at the correct rate and depth. If one has received proper training and is confident, they may also administer rescue breaths in conjunction with compressions. Otherwise, hands-only CPR is recommended, focusing solely on chest compressions until professional help arrives.
Knowing how to execute CPR effectively is essential since it can significantly impact the outcome for an individual in cardiac distress. Training and refreshers on the technique are recommended, so one can act confidently and swiftly should the need arise. It’s about preserving life and giving victims the best possible chance until emergency services can take over.
Last reviewed: September 2026 — checked against Resuscitation Council UK Guidelines 2025.
Recognising a Cardiac Arrest
Identifying a cardiac arrest in an adult promptly can make a critical difference. It’s vital that one can assess the victim and call for emergency services without delay — under the Resuscitation Council UK Guidelines 2025, that means calling 999 for any unresponsive person, before checking their breathing.
Assessing the Adult Victim
When an adult is suspected to be in cardiac arrest, it is necessary to assess their responsiveness. If one finds an individual unresponsive, they should call 999 straight away (see below) and then check for normal breathing while waiting for the call to be answered. Agonal breathing, which may be an occasional gasp or shallow breath, should not be mistaken for normal breathing. An absence of or abnormal breathing pattern in an adult who is unresponsive should be assumed to indicate a cardiac arrest.
Calling Emergency Services
Call 999 (or 112) as soon as you find that the person is unresponsive — you no longer need to confirm that their breathing is abnormal before phoning. Ideally a bystander makes the call, but if you are alone, activate your phone’s speaker function and call 999 without delay, then assess breathing while you wait for the call to be answered. It is essential to provide clear and concise information to the emergency operator, including the exact location and the apparent condition of the adult victim. Always stay on the line until instructed to hang up: the call handler will help you identify abnormal breathing if you are unsure, and will provide guidance on administering CPR before the paramedics arrive.
Basic Life Support Steps
Basic Life Support (BLS) is a critical process in emergencies where someone’s breathing or heart has stopped. The steps involve ensuring safety, assessing responsiveness, calling 999, managing the airway, checking for breathing, and providing chest compressions and rescue breaths if necessary.
Safety and Response
One must first ensure the area is safe for themselves and the injured person. They must then check for responsiveness by gently shaking the person’s shoulders and asking loudly, “Are you alright?”
Call 999
If there is no response, call 999 immediately — for any unresponsive person, before assessing their breathing. Ask a bystander to call if one is available; if you are alone, use your phone’s speaker function so your hands remain free. The ambulance service call handler will support you through the next steps.
Airway Management
While waiting for the 999 call to be answered, open the person’s airway by tilting the head back and lifting the chin. It is vital to ensure the airway is clear of any obstructions.
Breathing Check
The next step is to check for normal breathing, looking for chest movements, listening for breath sounds, and feeling for breath on their cheek, which should be conducted for no more than 10 seconds. Occasional gasps, or slow, laboured or panting breathing are not normal breathing — they are signs of cardiac arrest. If in doubt, assume cardiac arrest and start CPR; the call handler will assist you.
Chest Compressions
If the person is not breathing normally, chest compressions should be initiated immediately. Compressions should be firm and deep, at a depth of 5 to 6 cm, with a rate of 100 to 120 compressions per minute.
Rescue Breaths
If you have been trained to give rescue breaths, give two after every 30 chest compressions. To perform a rescue breath, tilt the person’s head, lift their chin, pinch the nose shut, and give two full breaths into the person’s mouth, each just enough to make the chest start to rise. If you are not trained to provide rescue breaths, or are unwilling to give them, perform continuous chest compressions without interruptions (hands-only CPR).
Using an Automated External Defibrillator (AED)
When a cardiac arrest occurs, the use of an Automated External Defibrillator (AED) can be critical in increasing the chances of survival. In the UK, it is recognised by Resuscitation Council UK that the involvement of bystanders in applying AEDs alongside CPR makes a notable difference to outcomes. Send someone to fetch the nearest AED as soon as possible — the 999 call handler can direct you to it — and attach it as soon as it is available. Anyone can use an AED; no training is needed.
AED Setup
To use an AED, one initially needs to power on the device. After checking that the area is safe, they must expose the patient’s chest to ensure proper pad placement. The AED kit typically includes a pair of pads and an instruction manual, though many modern AEDs provide vocal instructions as well.
- Switch on the AED: Locate and press the power button.
- Prepare the Patient: Remove any clothing from the chest and wipe it dry.
- Attach AED Pads: Follow the diagrams on the AED pads to place them correctly on the patient’s bare chest.
AED Application
Once the AED is set up, the individual must apply the pads correctly to allow the device to analyse the patient’s heart rhythm. Correct placement is crucial; one pad is placed to the right of the chest, below the collarbone, and the other to the left side, below the armpit. For a more detailed walkthrough, see our guide on the proper placement of defib pads.
- Position of Pads:
- Right Pad: Below the right collarbone.
- Left Pad: Lower left side of the chest.
Applying the AED pads to a bare chest allows for a more accurate reading and ensures that the pads stick properly. If more than one rescuer is present, continue CPR while the pads are being attached.
Following AED Prompts
After the pads are correctly applied, the defibrillator will analyse the heart’s rhythm. It is vital that everyone stands clear of the patient while the AED analyses and, if necessary, delivers a shock. The AED will provide vocal instructions on if and when to administer CPR.
- Clear the Area: Ensure everyone is away from the patient during analysis.
- Follow Instructions: The AED will guide the user through voice prompts.
- CPR Intervention: If instructed, perform CPR and follow the timed prompts of the AED. Restart chest compressions immediately after a shock has been delivered, or if no shock is indicated.
The above steps highlight the basics of using a defibrillator in a situation where an individual suffers from cardiac arrest. Familiarising oneself with these steps can prepare a person to act promptly and effectively, which is critical for increasing the patient’s survival odds.
CPR Technique and Quality
High-quality CPR technique is essential for increasing the patient’s chance of survival. Precise hand placement, adequate compression depth and rate, and minimal interruptions are vital components of effective CPR.
Hand Placement
The rescuer should place the heel of one hand in the centre of the chest, on the lower half of the breastbone, and then lay the other hand on top, interlocking the fingers. They must ensure that pressure is applied straight down on the sternum, avoiding pressing on the ribcage or stomach. Keep the arms straight, with the shoulders vertically above the person’s chest.
Compression Depth and Rate
- Depth: Compressions should be at least 5 centimetres but not exceeding 6 centimetres deep.
- Rate: Aiming for a rate of 100 to 120 compressions per minute is crucial for maintaining blood circulation. Allow the chest to recoil completely after each compression and avoid leaning on the chest.
One’s training and regular practice help maintain the necessary muscle memory and efficiency for achieving these requirements.
Minimising Interruptions
To ensure the maximal benefit of chest compressions:
- Limit interruptions to less than 10 seconds.
- Quickly swap between performing compressions and providing rescue breaths, if trained to do so.
It is important that everyone involved in CPR provision refreshes their training regularly to maintain skill proficiency and understand the latest CPR steps, thereby reducing the potential for interruptions during an emergency response.
Special Circumstances
When administering cardiopulmonary resuscitation (CPR), certain scenarios require adaptation from the standard protocol. Understanding these specific circumstances is crucial in providing effective aid.
CPR in Public Places
In public places, the presence of bystanders can significantly influence the administration of CPR. Bystanders trained in basic life support can initiate CPR before medical professionals arrive. It is advised for individuals to use hands-only CPR if they are not trained or not fully confident in performing rescue breaths. Emergency services should be alerted as soon as the person is found unresponsive, and one should check for accessible equipment like automated external defibrillators (AEDs), which are often located in public venues.
CPR with Multiple Rescuers
If there are multiple rescuers, they should coordinate to provide advanced life support (ALS) if they are trained to do so. Taking turns in performing chest compressions can help prevent fatigue and maintain the quality of compressions. They should follow the Resuscitation Council UK guidelines to ensure synchronicity in their efforts and maximise the patient’s chance of survival. It is critical that rescuers communicate effectively, swapping roles every two minutes to ensure consistency and efficiency.
Aftercare Following Resuscitation
Following successful resuscitation, it is crucial to place the individual in a stable position and monitor their condition continuously until emergency services arrive. Ensuring airway patency and responding to any changes in their status are key priorities.
Recovery Position
If the individual is breathing but remains unconscious after resuscitation, they should be placed in the recovery position. This involves:
- Laying the individual on their side, ensuring they are supported so they do not roll onto their face or back.
- Extending the arm they are lying on and placing the other arm at a right angle, creating a stable structure.
- Bending the knee that’s on top upwards to prevent rolling.
- Checking that the airway remains clear and is not obstructed by the tongue or vomit.
Continued Care
Until the ambulance arrives, continued care involves:
- Regularly monitoring breathing and responsiveness. If the individual stops breathing at any point, cardiopulmonary resuscitation (CPR) may need to be recommenced.
- Assessing airway, breathing and circulation (the ‘ABC’ of first aid) at frequent intervals.
- Keeping the individual warm and comfortable, using blankets or coats if necessary.
- Not providing any food or drink, as this can present a choking risk to someone who is only partially conscious.
- Reassuring the individual if they regain consciousness, explaining what has happened and that help is on the way.
Legal and Ethical Considerations
When addressing the legal and ethical considerations of cardiopulmonary resuscitation (CPR), one must consider the aspects of consent and the presence of Do Not Attempt CPR (DNACPR) orders. These facets are guided by overarching principles set by entities such as the Resuscitation Council UK and the National Institute for Health and Care Excellence (NICE).
Consent to CPR
In the UK, consent is a critical component of performing CPR on an adult. Healthcare professionals are tasked with ensuring that consent, where possible, is obtained before commencing resuscitation. This aligns with guidelines from the Resuscitation Council UK, which stress the importance of considering the patient’s autonomy and wishes. In emergency situations where a person is unable to give consent due to incapacitation, it is assumed that they would want to be resuscitated unless there is evidence to the contrary.
Do Not Attempt CPR (DNACPR) Orders
A DNACPR order is a medical decision that CPR should not be carried out, as it would not be in the best interests of the patient. It is a determination made after careful consideration of the patient’s health status, taking into account their wishes, beliefs, and values. The Resuscitation Council UK collaborates with healthcare professionals to provide clear ethical guidelines that should be considered when creating DNACPR orders. Such orders are also made following the NICE guidelines, ensuring that they are based on the most current evidence and best practice standards.
CPR for Different Demographics
When performing CPR, it’s crucial to understand that procedures and techniques vary depending on the age of the patient. Specific adaptations are necessary for children, infants, and special cases such as pregnant individuals.
Differences in CPR for Children and Infants
Children and infants require modified CPR techniques due to their smaller body size and different physiological needs. The most important difference is that every child and infant should receive five initial rescue breaths before chest compressions begin. For children over 1 year of age, use one or two hands as needed to compress the chest by at least one-third of its depth, at a rate of 100 to 120 compressions per minute — compared to adults, where two hands are used to achieve the recommended depth of 5-6 cm. For infants under 1 year old, current UK guidance is the two-thumb encircling technique rather than two fingers. For the full step-by-step technique, see our dedicated guide on how to perform CPR on a child or infant.
CPR Adaptations for Pregnant Victims
Pregnant individuals may need particular adjustments while performing CPR to increase the chances of survival for both the mother and the unborn child. Our dedicated guide explains how to perform CPR on a pregnant woman in the UK in full. It involves manually displacing the uterus to the left, which can improve blood flow during CPR. Chest compressions should still be administered at the standard rate of 100 to 120 compressions per minute, pressing down by 5 to 6 cm. However, during the advanced stages of pregnancy, a team approach is advised to handle additional complications.
Training and Certification
Proper training and certification in cardiopulmonary resuscitation (CPR) are crucial for effectively performing this life-saving procedure. They equip an individual with the skills required to administer CPR in emergency situations.
CPR Training Courses
CPR training courses provide the theoretical knowledge and practical skills needed to perform CPR on adults, with specific courses also available for paediatric first aid. We offer a CPR Certificate Training Course that prepares participants for workplace emergencies, covering adult resuscitation techniques comprehensively. These courses often culminate in a certification that indicates the individual is trained in CPR and Basic Life Support (BLS), in line with the most current guidelines.
Maintaining CPR Skills
It is paramount that individuals maintain their CPR skills post-certification to ensure proficiency. To aid in this, organisations such as the Resuscitation Council UK offer a range of courses designed for healthcare professionals and trainers to keep their resuscitation practice updated. Regular refresher courses are recommended, as they help trained individuals remember the correct procedures and adapt to any new techniques that may have been introduced.
Improving Survival Rates
Effective measures in community awareness and immediate response can significantly enhance the chances of survival for individuals experiencing a cardiac arrest. These efforts are crucial in the critical minutes before emergency services arrive.
Community Awareness
The likelihood of surviving a cardiac arrest significantly increases with widespread public knowledge on how to perform CPR and use automated external defibrillators (AEDs). Initiatives to improve rates of bystander CPR and AED use have shown positive impacts on survival rates. Training and awareness campaigns, such as those led by the Resuscitation Council UK, aim to equip individuals with the necessary skills to respond effectively in the event of a cardiac emergency.
Importance of Immediate Response
When a heart attack leads to a cardiac arrest, every second is critical. Immediate initiation of CPR by a bystander, together with use of an AED, can double or even quadruple the chance of survival (Resuscitation Council UK, Guidelines 2025). The sooner defibrillation happens, the better the chance of a good outcome — which is why the Resuscitation Council UK’s advice is simply to use an AED as soon as one is available, rather than waiting. According to the British Heart Foundation, there are more than 40,000 out-of-hospital cardiac arrests in the UK each year, and fewer than 1 in 10 people survive — which is exactly why immediate bystander action matters so much. For more context, see the latest UK heart and circulatory diseases statistics.
Resources for CPR Knowledge
The availability of insightful resuscitation training resources and accessible online educational material is crucial for those seeking to learn or refresh their knowledge of CPR (cardiopulmonary resuscitation) techniques.
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