CPR – how to do it

What is it?

Cardiopulmonary resuscitation (CPR) is a life-saving skill that can be used if someone isn't breathing or if their heart has stopped. CPR is a skill anyone can learn. It involves chest compressions and mouth-to-mouth (rescue breathing) to help keep blood and oxygen flowing through the body. Without CPR, it takes only a few minutes for the brain to be damaged due to lack of oxygen.

When should it be done?

You should start CPR if a person:

• is unresponsive and not breathing normally
• isn't breathing at all.

If they're unconscious, try to wake them. If they're breathing regularly and normally, you don't need to start CPR but do call 111 for help. If their breathing changes and they are having difficulty breathing or stop breathing, then start doing CPR.

1. Assess any dangers 

Only approach the collapsed person if you think it’s safe to do so. Check for any immediate dangers such as traffic, or electrical hazards like downed power lines.

2. Check whether the person is responsive

If it’s safe to proceed, check to see if they’re responsive by giving a simple command or question such as “Can you hear me?”, “What’s your name?” or “Can you squeeze my hand?”, then grasp and squeeze their shoulders firmly. Moving or making a noise counts as a response.

Someone who’s taken an excessive amount of drugs or alcohol may react aggressively or unexpectedly. If you’re unsure of your safety, avoid being too close while you check to see if they're breathing.

If they don’t respond to your voice or touch, then they are unconscious and in danger of dying because of their airway becoming blocked.

3. Send for help

Call an ambulance by phoning 111 or ask someone else to call. It’s important to call 111 as soon as possible so that medical help is on its way. You will be keeping the person alive with CPR, but they need additional care to start their heart.

4. Open and clear their airway

When a person is unconscious their muscles relax, including their tongue. This is dangerous because the tongue can flop downwards against the back of the airway and block it, meaning they can’t breathe.

• Leave the unconscious person in the position you found them in to open and clear their airway.
• Tilt their head back and lift the chin.
• If you see anything in  their mouth, use 2 fingers to sweep it out.

5. Check to see if they’re breathing normally

When the airway is open and clear, check for normal breathing.

• Look and feel for movement of the lower chest and upper abdomen.
• Listen and feel for air coming from their mouth or nose.
• Ignore occasional gasps of air which are not enough to maintain life.

If the person is breathing, move them and support them on their side with their head tilted back and monitor their breathing.

Note: These CPR guidelines are based on NZ and Australian standards and are taken from the St John website. Other countries may follow different guidelines with regards to mask wearing and mouth-to-mouth contact.

To carry out chest compressions  

Put the person on their back, kneel beside them, then do the following:

1. Place the heel of ONE HAND in the centre of the chest.
2. Place the heel of your OTHER HAND directly on top of the first hand.
3. Keep your elbows locked and lean over the patient so your arms are straight.
4. Push down hard and fast 30 times (push down one-third of chest depth).
5. Don't worry about pushing too hard – good CPR requires you to push hard and fast.
6. Once you've completed 30 compressions (pushes) on their chest, breathe into their mouth.

To breathe into the person

1. Tilt the head back with one hand and lift the chin with the other.
2. Take a deep breath and seal your lips around the patient’s mouth.
3. You need to block the nose by pinching the soft part of the nose, or pushing your cheek against the nose.
4. Blow into the patient’s mouth until you see the chest rise.
5. Remove your mouth, take a fresh breath, and blow again into the patient’s mouth.

Don't give up – keep going until help arrives, or until they are revived (regain consciousness and start breathing on their own).

If you have someone to help you, one person can do the chest compressions while the other person breathes into the person’s mouth. If you can't breathe into the person’s mouth or are uncomfortable doing it, just perform chest compressions.

If an AED (automated external defibrillator) is available, attach it to the person ASAP and follow the directions. 

 

Image credit: New Zealand Resuscitation Council

Using an automated external defibrillator (AED) can also save someone’s life. If they receive treatment from an AED, along with CPR, before the ambulance arrives their chance of surviving is much greater. 

If there is an  AED available, attach it to the person as soon as you can and follow the directions. The AED will guide you with voice prompts to use it safely.

Read more about AEDs and an app showing where AEDs are located in Aotearoa New Zealand.

Items such as handkerchiefs, tissues and tea towels don’t provide any useful protection from transmission of disease and complicate the process of performing CPR.

Commercially available face masks or face shields and other similar barrier devices may provide some protection from transmission of disease. However, bear in mind the following:

• The risk of transmission of disease by CPR is extremely low.
• First aiders are most likely to have to perform CPR on a relative.
• Barrier devices may cause the first aider to inappropriately focus on the mouth-to-mouth aspect of CPR when chest compressions are the most important.
• Barrier devices complicate the process of performing CPR and are often not available when CPR is actually required.
• If a barrier device is immediately available and you’re comfortable using it, then you may choose to use it.