What is CPR?

CPR (short for cardiopulmonary resuscitation) is a first aid technique you can use on someone if they are not breathing or if their heart has stopped.

• CPR is a skill that everyone can learn — you don’t need to be a health professional to do it.
• Try to stay calm if you need to do CPR.
• Performing CPR may save a person’s life.
• If you know CPR, you might save the life of a family member or friend.

CPR involves chest compressions and mouth-to-mouth (rescue breaths). The aim is to circulate blood and oxygen in the body to keep the brain and vital organs alive until specialised treatment is available.

When should I start CPR?

Start CPR as soon as possible if a person is:

• unconscious (not responding to you)
• not breathing
• breathing abnormally (for example, gasping for air or grunting)

How to perform CPR — adults

• Watch this video from Royal Life Saving Australia about how to perform CPR on an adult.
• Read the DRS ABCD action plan and step-by-step instructions below.

Follow these steps before starting CPR. (Use the phrase “doctor’s ABCD” — DRS ABCD — to help you remember the first letter of each step.)

DRSABCD ACTION PLAN

Letter	Representing	What to do
D	Danger	Make sure that the area is safe for you and the person receiving CPR. Do not put yourself or others at risk. Remove the danger or the person.
R	Response	Look for a response from the person — loudly ask their name, squeeze their shoulders.
S	Send for help	If there is no response, call triple zero (000) and ask for an ambulance or ask someone else to make the call. Do not leave the person.
A	Airway	Open their mouth and check their throat and nose are clear of any vomit, blood, food or loose teeth. If there is something in their mouth: Place them in recovery position. Remove any obvious blockages. Open airways by gently tilting their head back and lifting their chin.
B	Breathing	Check they are breathing. Look, listen and feel for 10 seconds. Place your hand on their stomach, your ear to their mouth and look to see if their chest is rising and falling. If they are breathing normally, place them in recovery position. Stay with them. Keep checking their breathing until help arrives. If they are not breathing normally, start CPR.
C	CPR	Adults need 30 chest compressions, followed by 2 breaths. Continue this CPR cycle until help arrives, or they start breathing. Chest compressions are the most important part of CPR. Start chest compressions as soon as possible after calling for help.
D	Defibrillation	Attach an Automated External Defibrillator (AED) to the person if one is available. Do not leave the person alone or stop compressions in order to get an AED. Follow the voice prompts.

How to carry out chest compressions on an adult:

1. Place the person on their back on a firm surface, such as the ground. Kneel beside their chest.
2. Place the heel of your hand on the lower half of their breastbone, in the centre of the person’s chest. Place your other hand on top of your first hand and interlock your fingers.
3. Position yourself above the person’s chest.
4. Use your body weight (not just your arms) and keep your arms straight to press straight down on their chest. Their chest should be compressed by about a third.
5. Release the pressure. Pressing down and releasing is 1 compression.
6. Do 30 compressions.

How to give mouth-to-mouth to an adult:

1. Open the person’s airway by tilting their head and lifting their chin. Place one hand on their forehead or top of the head. Place your other hand under their chin to tilt their head back.
2. Pinch the soft part of their nose closed with your index finger and thumb.
3. Open their mouth with your thumb and fingers.
4. Breathe in and place your lips over the person's mouth, ensuring a good seal.
5. Blow steadily into their mouth for about 1 second, watch to see their chest rise. Turn your mouth away from their mouth. Watch for their chest to fall. Listen and feel for signs that air is being expelled. Keep the head tilt and chin lift position.
6. Take another breath and repeat steps mentioned above. Now you have taken 2 breaths.
7. If their chest does not rise, check their mouth again and remove any blockages. Make sure their head is tilted and chin is lifted to open the airway. Check that yours and the person’s mouth are sealed together, and the nose is closed so that air cannot easily escape. Take another breath and repeat.

Keep going with repeated cycles of 30 compressions then 2 breaths until:

• the person recovers — they start moving, breathing normally, coughing or talking — then put them in the recovery position
• it is impossible for you to continue because you are exhausted
• a healthcare professional arrives and takes over CPR
• a healthcare professional arrives and directs that CPR be stopped

Doing CPR is very tiring. If possible and with minimal interruption, swap between doing mouth-to-mouth and compressions so you can keep going with effective compressions.

If you can’t give breaths, doing compressions only without stopping may still save a life.

How to perform CPR — children over 1 year

Use these instructions only if the child's chest is too small for you to use both hands to do chest compressions. Otherwise, use the instructions for adult CPR above.

• Watch this video from Royal Life Saving Australia about how to perform CPR on a child.
• Read the DRS ABCD action plan and step-by-step instructions below.

Follow these steps before starting CPR. (Use the phrase “doctor’s ABCD” — DRS ABCD — to help you remember the first letter of each step.)

DRSABCD ACTION PLAN

Letter	Representing	What to do
D	Danger	Make sure that the child and everyone in the area is safe. Do not put yourself or others at risk. Remove the danger or the child.
R	Response	Check for a response from the child — loudly ask their name, squeeze their shoulder. If they respond – stay with them to make sure they recover.
S	Send for help	If there is no response — immediately phone triple zero (000) and ask for an ambulance, or ask someone else to make the call. Do not leave the child.
A	Airway	Open their mouth and check it is clear. If you see any fluids — place the child on their side to help drain it. If you see an object — place the child on their side and use your fingers (pincer grasp) to remove it. Open their airway — lay them on their back. Tilt their head by placing one hand on their forehead. Lift their chin by using your thumb and fingers to open their mouth. Lift the jaw up towards you.
B	Breathing	Check if the child is breathing. Look, listen and feel for 10 seconds: Look for movement of the child’s chest and stomach. Listen for breathing sounds by placing your ear over their mouth and nose. Feel for breaths on your face when you listen. If they are breathing normally, place them in the recovery position and stay with them. Check they are still breathing while you wait for an ambulance.
C	CPR	If they are not breathing normally, start CPR. Chest compressions are the most important part of CPR. Start chest compressions as soon as possible after calling for help.
D	Defibrillation	Attach an Automated External Defibrillator (AED) to the child if one is available. Follow the prompts. Do not leave the child alone or stop compressions in order to get an AED.

How to carry out chest compressions on a child over 1 year old:

1. Place the child on their back and kneel beside them.
2. Place the heel of one hand on the lower half of breastbone, in the centre of the child’s chest (use one or 2 hands depending on the size of the child and your own strength).
3. Position yourself above the child’s chest.
4. Keeping your arm or arms straight, press straight down on their chest by one third of the chest depth.
5. Release the pressure. Pressing down and releasing is 1 compression.
6. Push down fast at a rate of 100 to 120 compressions per minute.

How to give mouth-to-mouth to a child over 1 year old:

1. Open the child’s airway. Use a head tilt: place one hand on the child’s forehead or top of the head; lift their chin: put your other hand under the child’s chin to tilt the head back.
2. Pinch the soft part of the nose closed with your index finger and thumb.
3. Open the child’s mouth with your thumb and fingers.
4. Breathe in, open your mouth and place your lips over the child's mouth — make sure you have a good seal.
5. Blow steadily into their mouth for about 1 second, enough air to see their chest to rise.
6. After the breath, look at the child’s chest and watch for the chest to fall. Listen and feel for signs that air is being expelled. Keep the head tilt and chin lift position.
7. If the child’s chest does not rise, check the mouth again and remove any obstructions. Make sure the head is tilted and chin lifted to open the airway. Check that yours and the child’s mouth are sealed together, and the nose is closed so that air cannot easily escape. Take another breath and repeat.

Keep going with repeated cycles of 30 compressions then 2 breaths until:

• the child recovers — they start moving, breathing normally, coughing or talking — then put them in the recovery position
• it is impossible for you to continue because you are exhausted
• a healthcare professional arrives and takes over CPR
• a healthcare professional arrives and directs that CPR be stopped

Doing CPR is very tiring. If possible, with minimal interruption, swap between doing mouth-to-mouth and compressions so you can keep going with effective compressions.

If you can’t give breaths, doing compressions only without stopping may still save a life.

How to perform CPR — infants under 1 year old

• Watch this video from Royal Life Saving Australia about how to perform CPR on an infant.
• You can also read the DRS ABC action plan and step-by-step instructions below.

Follow these steps before starting CPR. (Use the phrase “doctor’s ABCD” — DRS ABCD — to help you remember the first letter of each step.)

DRSABCD ACTION PLAN

Letter	Representing	What to do
D	Danger	Make sure that the infant and everyone in the area is safe. Do not put yourself or others at risk. Remove the danger or the infant.
R	Response	Check for a response from the infant to a loud voice, or gently squeeze their shoulders. Do not shake the infant.
S	Send for help	If there is no response, phone triple zero (000) and ask for an ambulance, or ask someone else to make the call. Do not leave the infant.
A	Airway	Open the infant’s mouth. Check for any blockages – vomit or an object. If there any foreign materials in mouth – place the infant face down on your forearm with their mouth slightly downward and support their head. Remove any blockages with your little finger. Once foreign material is removed, open the airway by lifting their head gently into a neutral position (head and neck in line).
B	Breathing	Check if the infant is breathing. Look if their lower chest or upper abdomen move. Listen for air escaping their nose and mouth. Feel for movement of air at their mouth and nose. If they are not breathing normally and there is no response, place the infant on their back on a firm surface. Keep head in a neutral position. If the infant is breathing, place them down on your forearm in recovery position. Monitor their airway, breathing and responsiveness.
C	CPR	If they are not breathing normally, start CPR. Chest compressions are the most important part of CPR. Start chest compressions as soon as possible after calling for help.

How to carry out chest compressions on an infant under 1 year old:

1. Lie the infant on their back on a firm surface.
2. Find the lower half of their breastbone in the middle of their chest.
3. Place 2 fingers on the lower half of the breastbone in the middle of the chest.
4. Press down on their chest by one-third deep (you may need to use one hand to do CPR depending on the size of the infant).
5. Release the pressure. Pressing down and releasing is 1 compression.
6. Give 30 compressions.

How to give mouth-to-mouth to an infant under 1 year old:

1. Tilt the infant’s head back very slightly.
2. Lift the infant’s chin up. Be careful not to rest your hands on their throat and neck. This will stop the air getting to their lungs from the mouth-to-mouth.
3. Take a breath and cover the infant’s mouth and nose with your mouth, ensuring a good seal.
4. Blow steadily for about 1 second, watching for their chest to rise.
5. After your breath, turn your mouth away from the infant’s mouth. Look at the infant’s chest and watch for the chest to fall. Listen and feel for signs that air is being expelled.
6. Take another breath and repeat the above steps. This is now 2 breaths.
7. If their chest does not rise, check their mouth and nose again and remove any obstructions. Check their head is in a neutral position to open the airway. Make sure there is a tight seal around the mouth and nose with no air escaping when giving a breath.

Keep going with repeated cycles of 30 compressions to 2 breaths until:

• the infant recovers — they start moving, breathing normally, coughing, crying or responding — then put them in the recovery position (see above)
• it is impossible for you to continue because you are exhausted
• a healthcare professional arrives and takes over CPR
• a healthcare professional arrives and directs that CPR be stopped

Doing CPR is very tiring. If possible, with minimal interruption, swap between doing mouth-to-mouth and compressions so you can keep going with effective compressions.

If you can’t give breaths, doing compressions only without stopping may still save a life.

Using an automated external defibrillator (AED)

Using an AED can save someone’s life. You do not need to be trained to use it. The AED guides you with voice prompts telling you how to safely use it. The AED is used to treat sudden cardiac arrest (when the heart suddenly and unexpectedly stops pumping).

1. Attach the AED as soon as it is available and follow the prompts.
2. Continue CPR until the AED is turned on and the pads attached.
3. Place the AED as instructed — they should not be touching each other. Place the first pad below their right collar bone. Place the second pad on their left side under the arm pit. All pads have pictures on them showing how to best to put them on.
4. Make sure no-one touches the person while the shock is being delivered.
5. You can use a standard adult AED and pads on children over 8 years old. Children younger than 8 should ideally have paediatric (children’s) pads and an AED with a setting for children. If these aren’t available, then use the adult AED.
6. Do not use an AED on children under 1 year of age.

CPR training

CPR training courses are available for individuals, families, workplaces and community groups. It’s important to have first aid skills because it will make coping with an emergency situation easier.

St John Ambulance Australia offers a range of first aid courses. To contact St John Ambulance Australia in your local area, call 1300 360 455.

Royal Life Saving Australia organises training courses in first aid and resuscitation in every state and territory.

Resources and Support

• Learn more about cardiac arrest and defibrillators at NSW Health.
• You can participate in one of St John Ambulance Australia many first aid courses and learn to save a life.

Do you prefer to read in languages other than English?

A guide to CPR (cardiopulmonary resuscitation) is also available in other languages via Health Translations.