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CPR, AED, and Emergency First Aid: The Core Steps

CPR and AED use follow a fairly consistent sequence across major first-aid guidelines, such as those from the American Heart Association and the Red Cross. Here is the general flow for an adult. It is not a substitute for certified hands-on training, and local protocols can differ.

  1. 1. Check the scene, then check responsiveness

    Make sure the immediate area is safe for you to approach: traffic, fire, electrical hazards, or an unstable structure. Then tap the person's shoulders firmly and shout, Are you okay? to check if they respond. Look at the chest for no more than about 10 seconds. If they are unresponsive and not breathing, or only gasping, treat it as a cardiac emergency. Occasional gasps, called agonal breathing, are not normal breathing and can occur in the first minutes of cardiac arrest.

  2. 2. Call your local emergency number and find an AED

    Call your local emergency number immediately, or point at a specific bystander and tell them to call while you begin care, because vague requests often go unanswered. Common numbers include 911 in the US and Canada, 999 in the UK, 112 across the EU, 119 in Japan, and 120 in mainland China. Put the phone on speaker so the dispatcher can coach you. If an AED (automated external defibrillator) is nearby, send someone to retrieve it. Most public buildings, airports, gyms, and shopping centers have one clearly marked and mounted on a wall.

  3. 3. Begin chest compressions

    Place the heel of one hand on the center of the chest, on the lower half of the breastbone, the other hand on top, with your arms straight and shoulders over your hands. Push hard and fast, about 5 to 6 cm (2 to 2.4 inches) deep at a rate of 100 to 120 compressions per minute, allowing the chest to fully rise between compressions. The beat of a familiar song with that tempo can help you keep rhythm. Continuous, uninterrupted compressions matter more than perfect technique, and you should minimize pauses. Compressions are tiring, so if another person is present, switch about every two minutes.

  4. 4. Give rescue breaths at a 30:2 ratio (if trained)

    After 30 compressions, tilt the head back, lift the chin, pinch the nose, and give 2 rescue breaths, each lasting about a second and making the chest visibly rise. Then go straight back to compressions. If you are not trained in rescue breaths or are uncomfortable giving them, continuous hands-only compressions are still effective and better than stopping. For a collapse caused by a breathing problem, such as drowning or overdose, breaths are especially valuable, so give them if you are able.

  5. 5. Use the AED as soon as it arrives

    Turn the AED on and follow its voice prompts exactly. Bare the chest, dry it if it is wet, and remove medication patches if they are in the way. The device will guide you through pad placement, usually one below the right collarbone and one on the lower left side under the armpit, and tell you when to stand clear while it analyzes the heart rhythm and, if needed, delivers a shock. Do not touch the person during analysis or the shock. After the shock, or if no shock is advised, resume compressions immediately when the AED instructs you to. An AED will not shock a heart that does not need it, so it is safe for untrained people to use.

  6. 6. Once breathing resumes, use the recovery position

    If the person starts breathing normally on their own, roll them onto their side with the head tilted slightly back to keep the airway clear. The upper knee is bent to stabilize the body. Stay with them, monitor breathing, and be ready to start CPR again if it stops, until emergency responders arrive.

  7. 7. Continue until help takes over

    Do not stop compressions until the person starts to move or breathe normally, an AED tells you to pause, trained responders take over, or you are too exhausted to continue. Rib fractures can happen with proper compressions, and rescuers are advised not to stop because of that fear, because the alternative to a cracked rib is cardiac arrest without circulation. Once responders arrive, tell them how long the person has been down, how many shocks were given, and anything you know about their health.

  8. Burns and bleeding

    Burns: cool the area under cool, not ice-cold, running water for 10 to 20 minutes and cover loosely with a clean non-stick dressing or plastic wrap. Do not apply ice, butter, or ointments, and do not pop blisters. Seek care for burns larger than the person's palm, burns on the face, hands, or genitals, deep burns, or burns from chemicals or electricity. Bleeding: apply firm, direct pressure with a clean cloth and elevate the wound above the heart if possible. If blood soaks through, add more cloth on top rather than removing the first layer. Call emergency services for heavy bleeding that does not slow after several minutes of pressure.

  9. Choking and fractures

    For a conscious adult who cannot speak, cough, or breathe, current American Heart Association guidance for adults and children is to alternate 5 back blows with 5 abdominal thrusts until the object comes out or the person becomes unresponsive, then begin CPR. Some other organizations teach the sequence a little differently, so follow the method you were trained in. Infants have a distinct technique using back blows and chest thrusts. For suspected fractures, immobilize the area in the position found rather than trying to realign it, do not let the person eat or drink if surgery may be needed, and call for help if there is a deformity, severe pain, or numbness.

  10. Stroke, seizures, and anaphylaxis

    Stroke: use the FAST check, which stands for Face drooping, Arm weakness, Speech difficulty, Time to call emergency services. Note the time the symptoms started, because treatment depends on it. Seizures: clear the area of hazards, cushion the head, do not restrain the person or put anything in their mouth, time the seizure, and roll them onto their side when the shaking stops. Call emergency services if a seizure lasts more than 5 minutes, repeats, or the person is injured, pregnant, or does not wake normally. Anaphylaxis, a severe allergic reaction: use an epinephrine auto-injector immediately if one is available, call emergency services without delay, have the person lie down with legs raised if they feel faint, and be aware that symptoms can return even if they seem to improve.

Adjustments for children and infants

For children, roughly age 1 to puberty, the compression depth is about one third of the chest, around 5 cm, sometimes using one hand instead of two depending on body size, with the same 30:2 ratio for a single rescuer. Many guidelines advise two rescuers to use 15:2. For infants under 1 year, use two fingers or two thumbs with the hands encircling the chest, compress about 4 cm deep or one third of the chest, and give gentle breaths that just make the chest rise, since an infant's airway is much smaller and more delicate. Most AEDs have pediatric pads or a pediatric mode for young children; if neither is available, using adult pads is better than no shock. In children, cardiac arrest more often follows a breathing problem, so breaths matter more. This page provides general guidance only.

Why bystander CPR matters and why training still helps

Cardiac arrest is a leading cause of death in many countries, and survival odds fall quickly with each minute without circulation. Bystander CPR and early defibrillation can make the difference between life and death, and professionals stress that doing something is better than waiting. Even so, a certified course, widely offered by organizations like the American Heart Association, the Red Cross, and local fire services, is the only reliable way to build real competence and confidence, because you practice on a manikin with feedback on depth and rate. Guidelines are periodically revised, so refresh your training every two years or as your provider recommends.

Frequently Asked Questions

Should I still do CPR if I am not trained in rescue breaths?

Yes. Hands-only CPR, which is continuous chest compressions without rescue breaths, is endorsed by major first-aid organizations as an effective option for untrained bystanders on an adult, and is far better than doing nothing while waiting for help to arrive.

What is the recovery position actually for?

It keeps the airway open and lets fluids, such as vomit, drain out of the mouth rather than being inhaled. That is important for someone who is breathing but not fully conscious while you wait for emergency responders.

Can I hurt someone by doing CPR when they are not in cardiac arrest?

Check first that the person is unresponsive and not breathing normally. Injuries from CPR on someone who did not need it are uncommon and usually minor compared with the risk of withholding CPR from someone who does.

How fast and how deep should compressions be?

About 100 to 120 per minute, and about 5 to 6 cm deep on an adult. Let the chest rise fully between compressions and keep pauses as short as possible.