How to Resuscitate an Unconscious Person

When performing cardiopulmonary resuscitation (CPR), remember your ABCs: Check the airway first for obstructions, then check for breathing and finally for circulation.

Instructions

Difficulty: Challenging

Assisted breathing

1. Tell somebody to call 911. If a neck, head or back injury may be involved, do not move the unconscious person unless he or she is in imminent danger. Wait for medical help to arrive.
2. Use two fingers to check the airway. Clear any visible foreign objects from the mouth. Remove loose dentures or retainers.
3. Lay the victim on a hard, flat surface. Tilt the head back by placing one hand on the forehead and one on the chin. Place your head near the victim's mouth to listen or feel for breathing; watch to see if the chest is rising and falling.
4. If the victim is not breathing, close the nostrils with your thumb and index finger. Keep the victim's head tilted back with your other hand on the chin. Take a deep breath and seal your mouth over the victim's mouth (see A). For small children, cover both mouth and nose. Exhale two full breaths, each lasting 1 1/2 to 2 seconds for an adult or a child over 8; 1 to 1 1/2 seconds for children ages 1 to 8. Remove your mouth between breaths to allow the victim to exhale.
5. Watch the chest to see if it is rising with each breath. If it is not, make sure you've tilted the head back enough. If an object is lodged in the airway, perform the Heimlich maneuver (see How to Stop Someone From Choking).
6. Check the pulse: Keep one hand on the forehead while you put two fingers (not your thumb) on the neck alongside the Adam's apple (see B). Press down 5 to 10 seconds to feel for a pulse.
7. If you feel a pulse, continue with the breathing: two breaths every 5 seconds for adults and children over 8 (12 breaths per minute),or two breaths every 3 seconds for children ages 1 to 8 (20 breaths per minute).
8. Breathe in deeply between each breath. Make sure the victim's chest depresses in exhalation between breaths. Continue until help arrives or until the victim resumes breathing independently.

Chest compressions

9. If you don't feel a pulse, begin chest compressions. Find the breastbone (in the center of the chest where the ribs meet). Measure two fingers' width above the bottom of the breastbone. Put the heel of your hand there. Kneel next to the victim and place your other hand on top of the first one. Interlock your fingers to provide extra force (see C). For children ages 1 to 8, use only one hand for compressions.
10. Keep your elbows locked straight and your shoulders directly above your hands as you gently push onto the breastbone with the heel of your hand (see D). Push the chest down 1 1/2 to 2 inches (4 to 5 cm) in 15 rapid yet smooth thrusts for adults and children over 8; 1 to 1 1/2 inches (2.5 to 4 cm) five times for children ages 1 to 8. Allow the chest to rise between thrusts but do not remove your hand from the chest. Count aloud as you go.
11. Breathe two breaths into the victim's mouth using the process described in "Assisted breathing".
12. Alternate 15 chest compressions and two breaths four times for adults and children over 8; five compressions and one breath 20 times for children ages 1 to 8. Then quickly check for a pulse.
13. If you don't feel a pulse, continue rotating between 15 compressions and two breaths--about 80 to 100 compressions per minute--for adults and children over 8; five compressions and one breath for children ages 1 to 8.
14. Check the pulse every minute or so. Continue until the victim has a pulse and resumes breathing or until medical help arrives.

Tips & Warnings

• Stay calm and act quickly; every second counts. Continue CPR until help arrives.
• If the victim vomits, turn the head to the side, use two fingers to clear out the mouth, and continue resuscitation efforts.
• If you have assistance, one person can do chest compressions while the other person handles breathing. Alternate five compressions and one breath. The person doing the breathing should check for a pulse between breaths.
• Enroll in CPR classes to learn the proper procedures in person, especially if you work with children or the elderly or if you are expecting a baby. Contact a local branch of the American Heart Association or the American Red Cross to find out about courses.
• Do not perform CPR on a victim who is still breathing or chest compressions on a victim who has a pulse. You risk causing greater injury.
• A person should receive professional training from a certified instructor prior to administering CPR. These instructions are not intended to replace CPR courses.
• Resuscitating an unconscious infant (younger than 12 months) requires quite different techniques. Ask your pediatrician or healthcare provider to recommend a certified infant CPR course.