Knowing how to position CPR correctly separates compressions that move blood from compressions that only tire the rescuer. Roughly 350,000 Americans suffer cardiac arrest outside a hospital each year, and most collapse at home or work with someone nearby. This guide covers cpr steps and techniques in the order you would use them: scene safety, patient position, hand placement, compressions, breaths, and defibrillator use, plus the adjustments needed for children and infants.
Position matters before your hands ever touch the chest. The person must lie face up on a firm, flat surface, such as the floor, because a mattress or couch absorbs force and cuts compression depth. Kneel beside the shoulders, keep your knees about shoulder width apart, and stack your hands on the lower half of the breastbone. Your shoulders should sit directly over your hands with straight elbows, so your body weight, not your arm muscles, drives each push.
Rate and depth are the two numbers worth memorizing. Adults need compressions at 100 to 120 per minute, which matches the beat of songs like Stayin' Alive, and a depth of at least 2 inches but no more than 2.4 inches. Allow the chest to recoil fully between pushes, since incomplete recoil keeps pressure high inside the chest and starves the heart of refilling time. Interruptions should stay under 10 seconds whenever possible.
Many readers arrive here from searches that mix unrelated topics. CPR Cell Phone Repair, for example, is a retail electronics chain and has nothing to do with resuscitation, while the National CPR Foundation is an actual training provider that offers online courses and certificates. Whichever provider you consider, confirm that your employer, school, or licensing board accepts its card, because acceptance rules differ and hands-on skills practice is often required for workplace credentials.
This article is educational awareness content, not a substitute for a hands-on class. Reading about chest compressions builds familiarity, but muscle memory comes from practicing on a manikin with feedback, ideally with an instructor who corrects your hand placement and rate. If you have never practiced, the first time you feel how hard 2 inches of compression really is can be startling, and that surprise is better experienced in a classroom than during a real cardiac arrest.
Terminology also trips people up. Basic CPR is taught to the public, while life support courses are tiered: Basic Life Support (BLS) is for healthcare providers, the ACLS algorithm covers advanced adult cardiac care, and PALS certification covers pediatric emergencies. Layperson CPR comes first in every chain. If you can recognize cardiac arrest, call 911, push hard and fast, and use an AED, you have already completed the steps that save most lives before paramedics arrive.
Below you will find a step-by-step timeline, a quick CPR index of numbers worth remembering, an explanation of the recovery position, a comparison of adult, child, and infant CPR, and practical tips for retaining skills. Take the free practice questions after each section to test yourself. Even a few minutes of review improves confidence, and confidence is what turns a frightened bystander into someone who actually starts compressions when seconds count.
Make sure the area is safe, then tap the person's shoulders and shout. Look for normal breathing for no more than 10 seconds. Gasping or no breathing means cardiac arrest, so move straight to the next step without delay.
Point to a specific bystander and tell them to call 911 and bring the nearest AED. If you are alone, use speakerphone so the dispatcher can coach you while your hands stay on the chest.
Lay the person face up on a firm surface. Kneel beside the chest, place the heel of one hand on the lower half of the breastbone, stack the other on top, and lock your elbows.
Push at least 2 inches deep at 100 to 120 per minute, allowing full recoil. After 30 compressions, tilt the head, lift the chin, and give two one-second breaths. Untrained rescuers can do hands-only compressions.
Turn on the AED, attach pads to bare skin, and follow the prompts. Clear the person during analysis and shocks, then restart compressions immediately. Continue until paramedics take over or the person clearly wakes up.
Hand placement starts with finding the center of the chest. Place the heel of one hand on the lower half of the breastbone, between the nipples for most adults, then rest your second hand on top and interlock your fingers. Lift your fingers so only the heel of the hand contacts the chest. Pressing on the ribs or the soft tip of the sternum raises the risk of fractures and reduces effectiveness, so recheck your landmark after every pause.
Compression technique is mostly body mechanics. Lock your elbows, bring your shoulders directly above your hands, and hinge from your hips instead of bending your arms. Push straight down at least 2 inches, then release completely without lifting your hands off the chest. Count out loud if it helps. Fatigue sets in quickly, and studies show compression quality drops noticeably after about two minutes, so rescuers should switch roles every five cycles or two minutes when help is available.
Rescue breaths require a clear airway. Tilt the head back and lift the chin, pinch the nose, make a seal over the mouth, and deliver a breath lasting about one second that makes the chest visibly rise. Give two breaths after every 30 compressions, spending less than 10 seconds on them. If the chest does not rise, reposition the head and try once more, then return to compressions rather than wasting time on repeated attempts.
Untrained bystanders have a simpler option: hands-only CPR. Call 911, then push hard and fast in the center of the chest at 100 to 120 compressions per minute until help arrives or an AED is ready. Hands-only CPR is recommended for adults who suddenly collapse, because their blood still carries oxygen for the first several minutes. For children, drowning victims, or anyone whose arrest likely stems from breathing problems, rescue breaths are still advised.
Assessing breathing is where beginners hesitate. A normal respiratory rate for a resting adult is 12 to 20 breaths per minute, but a person in cardiac arrest is either not breathing or only gasping occasionally, a pattern called agonal breathing. Agonal gasps are not normal breathing. If the chest is not rising and falling regularly within 10 seconds, treat the situation as cardiac arrest and begin compressions immediately instead of waiting to see if breathing improves.
If you are giving breaths without compressions because a pulse is present, the rate differs by age. Adults receive one breath every six seconds, about 10 per minute, while children and infants receive one breath every two to three seconds, about 20 to 30 per minute. Each breath should be gentle and last one second. Overventilation is a common error that pushes air into the stomach, causes vomiting, and lowers blood flow back to the heart.
So what does AED stand for? It stands for automated external defibrillator, a portable device that analyzes heart rhythm and delivers a shock only when one is needed. Turn it on, follow the voice prompts, attach the pads to bare, dry skin, and stand clear during analysis. Resume compressions immediately after any shock. Modern AEDs are designed for untrained users, so there is no legal or practical reason to hesitate when one is available.
Adult CPR applies to anyone at or past puberty. Position the person flat on their back on a hard surface, kneel beside the chest, and use two hands stacked on the lower half of the breastbone. Compress at least 2 inches deep at 100 to 120 per minute. With one or two rescuers, the ratio is 30 compressions to 2 breaths, and an AED should be attached as soon as it arrives.
Adult cardiac arrest is usually caused by an electrical problem in the heart, most often ventricular fibrillation, which is why early defibrillation matters so much. Each minute without a shock lowers survival odds by roughly 7 to 10 percent. Because of this, send a second person to retrieve the AED while you compress. If you are alone and have a phone, put it on speaker so dispatchers can coach you without interrupting compressions.
Child CPR covers ages 1 through puberty. Use one or two hands, depending on the child's size, and compress about one-third the depth of the chest, roughly 2 inches. The rate remains 100 to 120 per minute. A lone rescuer uses 30 compressions to 2 breaths, but with two trained rescuers the ratio changes to 15:2 because children more often arrest from breathing problems than from heart rhythm disorders. Use pediatric pads on an AED if available.
If you are alone with a collapsed child, perform two minutes of CPR before leaving to call 911 or retrieve an AED, unless someone else can do it. This differs from adults, where calling first is the priority. Healthcare professionals who work with children often pursue PALS certification, which builds on basic CPR with rhythm recognition, medication dosing, and team-based resuscitation for pediatric emergencies, so the skills go well beyond what a layperson needs.
Infant CPR applies to babies under one year old. Lay the infant on a firm surface and, if you are alone, use two fingers placed just below the nipple line in the center of the chest. With two rescuers, use the two-thumb encircling technique, wrapping both hands around the chest. Compress about 1.5 inches deep, one-third of the chest depth, at 100 to 120 per minute, and allow full recoil each time.
Rescue breaths for infants cover both the mouth and nose with your mouth, using only small puffs of air from your cheeks. Do not tilt the head back as far as in adults; keep it in a neutral sniffing position. Ratios are 30:2 for one rescuer and 15:2 for two. Never perform blind finger sweeps, and use the brachial artery on the inner upper arm for pulse checks by trained providers.
The recovery position is only for people who are unresponsive but breathing normally. If breathing stops or turns to occasional gasps, roll the person onto their back and begin compressions right away. When unsure, choose CPR.
The recovery position is a different skill from CPR, and confusing them is a common mistake. Use it only when a person is unresponsive but breathing normally, such as after fainting, a seizure that has ended, or intoxication. Its purpose is to keep the airway open and let fluid drain from the mouth so the person does not choke or aspirate vomit while you wait for emergency responders to arrive and take over.
To place someone in the recovery position, kneel beside them and straighten both legs. Place the arm nearest you at a right angle to the body, palm up. Bring the far arm across the chest and hold the back of that hand against the near cheek. Bend the far knee, then roll the person toward you by pulling on that knee. Tilt the head back gently to keep the airway open.
Position recovery should never delay chest compressions. If the person stops breathing normally at any moment, roll them onto their back and start CPR. Keep checking breathing continuously, at least every minute, and note the respiratory rate if you can; a rate under 8 or over 30 breaths per minute in an adult is a warning sign. Turn the person to the opposite side every 30 minutes if help is delayed, to limit pressure injuries.
Avoid the recovery position when a spinal injury is suspected, such as after a fall from height or a diving accident, unless the airway cannot otherwise be maintained. In that case, a jaw-thrust without head tilt and log rolling with several helpers is preferred. Pregnant patients in late pregnancy benefit from lying on the left side, which relieves pressure on the large vein returning blood to the heart. Always tell dispatchers what position you chose.
CPR and recovery positioning fit within the chain of survival, a sequence of actions that improves outcomes in cardiac arrest. The out-of-hospital chain includes recognition and calling 911, early CPR, rapid defibrillation, advanced resuscitation by paramedics, post-cardiac arrest care, and recovery. Survival from out-of-hospital arrest averages about 10 percent nationally, but it can exceed 30 percent in communities where bystander CPR and public-access AEDs are common. Every link you strengthen helps the next one work.
Life support training is tiered. Basic Life Support covers high-quality CPR, AED use, and choking relief for healthcare providers. Advanced cardiovascular life support, or ACLS, adds rhythm interpretation, medications, and airway management for adults. PALS certification extends that framework to infants and children, with weight-based dosing and age-specific assessments. Each course expects you to hold a current BLS card first, and each typically requires renewal every two years to keep skills and guideline knowledge fresh.
The ACLS algorithm splits cardiac arrest into shockable rhythms, ventricular fibrillation and pulseless ventricular tachycardia, and non-shockable rhythms, asystole and pulseless electrical activity. Shockable rhythms get defibrillation, two-minute CPR cycles, epinephrine 1 mg every 3 to 5 minutes, and amiodarone 300 mg then 150 mg. Non-shockable rhythms focus on epinephrine and treating reversible causes, often remembered as the H's and T's. Bystanders do not run this algorithm, but understanding it shows why early compressions and shocks matter.
Choosing a CPR course starts with knowing who must accept your card. Nurses, EMTs, and most hospital staff need a BLS Provider card from the American Heart Association or an equivalent, and employers often specify this in writing. Childcare workers, coaches, and lifeguards may accept the American Red Cross or other providers. Before paying, ask your employer or licensing board for the exact provider, course name, and skills-session requirements so you do not end up retaking a class.
The National CPR Foundation is one provider frequently searched by people wanting a quick online certificate. It offers self-paced courses with an online exam and instant digital card. Some employers accept such cards for non-clinical roles, but many healthcare and regulated settings require an in-person skills check. Always verify acceptance first, and treat any provider promising a card without any skills component with caution, since the quality of your hands-on practice determines how you perform in an emergency.
Blended learning is the middle path. You finish the cognitive portion online, then attend a short in-person skills session where an instructor watches you perform compressions and breaths on a manikin and use a training AED. This format usually takes one to two hours on site, costs about the same as a classroom course, and satisfies most employers. It also protects you from cards that look official but lack any verified skill demonstration.
Typical US prices help with budgeting. A community CPR and AED class often costs between $25 and $75, a healthcare BLS course runs about $50 to $100, and ACLS or PALS courses commonly cost $150 to $300 depending on location and whether the fee includes the textbook. Renewal classes are usually shorter and cheaper. Some hospitals, fire departments, and community groups hold free or subsidized classes, so check local options before paying full retail.
PALS certification is intended for clinicians who care for acutely ill children, including pediatric nurses, emergency physicians, paramedics, and respiratory therapists. The course teaches systematic assessment, recognition of respiratory failure and shock, and the pediatric cardiac arrest algorithms. Candidates complete case-based megacode simulations and a written exam, with a passing score typically at least 84 percent. Parents and teachers do not need PALS; a pediatric-focused CPR and first aid class is a better match.
ACLS courses assume you can already perform high-quality CPR and read basic electrocardiograms. Expect two days for initial certification, or one day for renewal, with pre-course self-assessments. Instructors evaluate your ability to lead a resuscitation team, choose between shockable and non-shockable pathways, and communicate clearly in closed-loop fashion. Many people underestimate the rhythm interpretation portion, so reviewing basic rhythms and drug doses a week or two before class makes the course far more manageable.
Certification cards typically last two years, but skills fade much sooner. Research shows that compression quality declines within six months to a year after training if people do not practice. Set a reminder to refresh your skills every six months with a manikin, a training video, or a community session. Track your expiration date, since lapsed cards often require a full course instead of a shorter renewal. A calendar entry takes thirty seconds and prevents delays at work.
The best preparation is regular, low-pressure practice. Rehearse the sequence aloud once a month: check the scene, tap and shout, call 911, start compressions, retrieve the AED. Saying each step out loud builds a script your brain can follow under stress. Pair practice with something routine, like the first of the month, and use a pillow or manikin to feel the movement of locking elbows and rocking from your hips.
Use feedback whenever you can. Manikins with lights or sensors show whether your depth and rate land in range, and many smartphone apps use the phone's accelerometer to measure rhythm. A metronome set to 110 beats per minute works too. Most people compress too slowly or too shallowly at first, so measured feedback quickly reveals bad habits. Even five minutes of corrected practice improves performance more than an hour of passive video watching.
Know your environment. Learn where AEDs are located at work, your gym, your child's school, and places you visit regularly; they are usually mounted in white or green cabinets with a heart-and-lightning-bolt symbol. Store emergency numbers and your home address in a place where a child or guest can find them. If you live in a multi-story building, note elevator access so responders reach you faster, and consider unlocking the door early when a family member shows symptoms.
Prepare mentally for what CPR feels and sounds like. Ribs may crack, which does not mean you are doing it wrong; broken ribs are a recognized, survivable consequence of effective compressions. The person may gurgle, vomit, or make gasping sounds. Roll them to the side to clear vomit, wipe the mouth, and continue. Expect fatigue, sweating, and a racing heart in yourself. Remind yourself that continuing compressions is almost always better than stopping.
Legal worry stops some people from acting, but Good Samaritan laws in all 50 states protect bystanders who provide emergency care in good faith. These laws vary in details, so employees with a duty to respond, such as lifeguards and healthcare staff, should understand their own obligations. For the public, the guidance is simple: call 911, follow the dispatcher, and do what you were trained to do. Imperfect help is far better than no help.
Look after yourself afterward. Responders and bystanders alike can experience shock, guilt, or intrusive thoughts after a resuscitation, especially if the person did not survive. Talk with someone you trust, request a debrief if one is offered at work, and give yourself time. Remember that survival rates are low even with perfect technique, and that your attempt gave the person their only chance. Many communities offer peer support programs for lay rescuers.
Finally, turn knowledge into measurable readiness. Take the free practice quizzes linked on this page, note which questions you missed, and review those topics, such as compression depth for infants or the steps of AED pad placement. Check the expiration date of your certification and book a renewal now if it falls within three months. Share what you learned with family members, because the person most likely to need your help is someone you love.