How Do You Perform CPR on an Adult?

Almost everyone who has watched someone collapse says the same thing afterward. Not that they didn't know what to do — that they stood there for a few seconds first, waiting to be sure. Waiting for the person to move, or for somebody else to step in, or for it to turn out to be nothing.

Those few seconds are the part worth practicing. The technique is simpler than most people expect, and the hard part is deciding that it's time.

Unresponsive, and not breathing normally

There are two, and that's the whole test.

Both of those you can check in a few seconds, with nothing but your eyes and your voice. Tap the shoulders, shout, and watch the chest for five to ten seconds. Gasping, gurgling or snoring sounds aren't breathing — they're common in the first minutes, and they're the most likely reason somebody decides not to start. If you're not sure whether what you're seeing is real breathing, treat it as though it is not.

There is no pulse check here. Knowing what agonal breathing sounds like is worth a few minutes before you ever need it, and what changed in 2025 covers the rest.

Getting help on the way

Call 911 right away — before you start compressions, not after. Put the phone on speaker and set it down beside you so you can do both at once. The dispatcher will talk you through it, and they'd rather be on the line early.

If there are other people around, don't announce it to the room. A group hears "somebody call 911" and every person in it assumes somebody else did. Point at one person and describe them — "you, in the green shirt" — then give them all three jobs: call 911, find an AED, and come back. The coming-back part matters as much as the rest.

It might not be 911. Plenty of workplaces have their own emergency number, and if yours does, that's the one that gets somebody moving fastest. Worth knowing before the day you need it.

One thing to know if the person on the floor is a child rather than an adult: the timing advice is different, and deliberately so. CPR on a child and CPR on an infant each have their own rule about when to call, because the reasons a small body stops breathing usually aren't the reasons an adult's heart stops.

How to perform CPR on an adult: step-by-step

1. Check that the scene is safe. Traffic, live wires, fumes, an unstable surface. You cannot help anybody if you become the second patient.

2. Tap and shout. Firmly, at the shoulders. "Are you okay?"

3. Get help moving. Call 911 on speaker, and send a specific person for an AED.

4. Look for normal breathing for five to ten seconds. Gasping doesn't count.

5. Bare the chest if you can do it quickly. Clothing between your hands and the breastbone makes it harder to push well.

6. Put your hands in the middle of the chest and push hard and fast — the next two sections are about doing that part well.

7. Give 2 breaths after every 30 compressions, if you're willing and able. If not, keep pushing without stopping.

8. Keep going until help takes over, an AED is ready to use, or the person starts moving and breathing on their own.

Finding the spot on the chest

Hand placement is the part people get wrong quietly, because nothing tells you that you're in the wrong spot.

• Find the spot by tracing a line across from the armpit to the center of the chest. That lands you on the lower half of the breastbone, which is where you want to be.

• Heel of one hand down on that spot, then your other hand on top, fingers laced together and lifted off the ribs.

• Arms straight, shoulders stacked directly over your hands. You're pushing with your body weight, not your arms — arms tire out in about a minute, and this may take several.

• Kneel close beside the chest rather than reaching across. Leverage is most of this.

The four numbers that matter

The rate has an upper limit for a reason worth knowing, because it explains the whole set: pushing too fast or too deep is its own problem. The heart has to refill between compressions, and if you never let it, you're moving less blood rather than more. Letting the chest come all the way back up is as important as pushing down — and it's the thing people stop doing first when they get tired.

For the tempo, counting out loud works and so does humming something. "Stayin' Alive" is the famous one and it genuinely sits in the right range. Whatever keeps you honest.

Breaths, and when to skip them

Two breaths after every thirty compressions. Tilt the forehead back, lift the chin, pinch the nose shut, and cover their mouth with yours — or with a barrier device if you've got one. Each breath takes about a second, and you're watching the chest, not counting.

If the chest doesn't rise, reposition the head once and try again. Don't spend a third attempt on it — get back to compressions.

And if you're not going to give breaths, that's a real option rather than a failure. Plenty of people won't put their mouth on a stranger, and hesitating over it costs more than skipping it does. Compression-only CPR is its own approach with its own reasoning, and for an adult who collapses suddenly it works.

When you can stop

• Someone takes over — paramedics, or another trained person.

• An AED is ready to use. Turn it on and follow it; it will tell you when to resume. It decides whether to shock, not you.

• The person starts moving, breathing or responding on their own.

• You physically cannot continue. Swap with somebody every couple of minutes if you can — good compressions get worse fast, and most people overestimate how long they can keep going.

Why the order matters

Everything above is arranged around one idea:

1. 1 Recognize & respond
2. 2 Call 911
3. 3 Start CPR
4. 4 Defibrillate (AED)
5. 5 Advanced care

Recognizing it starts the clock. Calling brings people who can do more than you can. Compressions keep blood moving to the brain while everyone waits. A defibrillator is the thing that can actually restart a heart in the rhythm that causes most of these — and it works best early. Then hospital care, then recovery.

That's why the call happens now instead of after five cycles, and why you send someone for the AED before you need it. You are not just helping — you are holding the line until the part that fixes it can get there.

Put it into practice

Training scenario:

You're in line at a coffee shop on a weekday morning. A man ahead of you sits down heavily on a chair, then slides onto the floor. He's not moving. There are maybe fifteen people in here, two staff behind the counter, and everyone has turned to look. Nobody has moved. Someone says "is he okay?" and someone else says "I think someone's calling."

Walking it through:

The dangerous sentence is "I think someone's calling." Nobody is. Fifteen people each assumed one of the other fourteen had it handled, which is what a crowd reliably does — and it's why the fix is so specific. You don't ask the room. You pick a face, describe them out loud so they know they've been picked, and give them the whole job: call 911, find an AED, come back.

Then the two signs. He's not responding to a shout and a shoulder tap. Watch the chest for five to ten seconds — and if he makes a sound like a snore or a gasp somewhere in there, that is not breathing, and it's the most common reason people wait. You're not checking a pulse. You have what you need.

So: hands on the lower half of the breastbone, shoulders over your hands, and push. Two inches, a hundred to a hundred and twenty a minute, letting the chest come back up each time. Send someone to the door to wave the ambulance in. And when the second person offers to take over — say yes, at about two minutes, before your compressions get shallow without you noticing.