By the end of this guide, you will understand the correct sequence for performing CPR on an adult, from checking the scene to continuing compressions until help arrives. No equipment is required to start, though you should be trained or willing to seek certification through a course such as those offered by Midwest CPR Center. As of 2026, resuscitation guidelines are periodically updated by organizations like the American Heart Association, so it is worth confirming you are working from the most current recommendations even after you finish reading.
Step 1: Check the Scene and the Person
Before you touch anyone, look around. Is there oncoming traffic, downed power lines, smoke, or an aggressive individual nearby? If the scene is not safe, you cannot help the person effectively, and you risk becoming a second victim. Move the person only if leaving them in place puts both of you in immediate danger.
Once you have confirmed it is safe to approach, kneel next to the person and check for responsiveness. Tap their shoulder firmly and shout something like "Are you okay?" close to their ear. You are looking for any purposeful response: opening their eyes, speaking, or moving. If there is none, treat this as an emergency.
Next, check breathing. Look at the chest and abdomen for movement while you tilt your head to listen and feel for airflow. Do this for no more than 10 seconds. This is where a common mistake happens: mistaking agonal gasping for normal breathing. Gasping looks like irregular, labored gulps, sometimes with long pauses between breaths, and it is a sign of cardiac arrest, not adequate breathing. If the person is not breathing normally, or you are unsure, assume they need CPR and move immediately to the next step.
Lay rescuers should not stop to check for a pulse. Pulse checks are difficult even for trained medical professionals under stress, and the time spent searching for one delays compressions that the person needs right away. If someone is unresponsive and not breathing normally, start CPR without hesitation.
Step 2: Call 911 and Get an AED
If other people are nearby, do not simply yell "someone call 911." Point at a specific person and give a direct instruction: "You, in the blue shirt, call 911 now and tell me when you're connected." Ambiguous requests to a crowd often result in no one acting, because each bystander assumes someone else will do it.
Assign a second bystander a different task: locating and bringing an automated external defibrillator, commonly known as an AED. Many public buildings such as schools, gyms, airports, and offices have one mounted on a wall, often marked with a sign. Tell the bystander clearly where to look if you know, such as "check by the front entrance or near the elevators."
If you are alone with the person and have a phone, call 911 yourself before starting compressions, but put the call on speaker and set the phone on the ground near the person's head. This lets the dispatcher guide you through CPR while you begin compressions immediately, rather than losing time going back and forth to the phone. Dispatchers are trained to walk callers through hands-only CPR step by step, so speaking with one is not a substitute for acting, it is a way to get real-time support while you act.
Step 3: Position the Person and Yourself
Effective compressions require a firm, flat surface. If the person is on a bed, couch, or other soft surface, move them to the floor if you can do so safely. Compressions performed on a mattress absorb much of the force, making them far less effective at circulating blood.
Lay the person flat on their back with their arms at their sides. Kneel beside their chest, positioning your body so you can lean directly over them. If clothing is in the way, such as a heavy jacket or a shirt with buttons or zippers, move or cut it aside so you have clear access to the sternum, the flat bone running down the center of the chest.
To find proper hand placement:
- Locate the center of the chest, roughly between the nipples on the sternum.
- Place the heel of one hand on that spot, keeping your fingers off the ribs.
- Place your other hand directly on top and interlace your fingers so they lift slightly off the chest.
- Straighten your arms and position your shoulders directly over your hands so you can push with your body weight rather than just your arms.
This positioning matters because it lets you deliver consistent, deep compressions without tiring quickly, and it reduces the risk of injuring the person's ribs from off-center pressure.
Step 4: Perform Chest Compressions
With your hands positioned on the lower half of the sternum and your shoulders stacked directly above them, push straight down using your body weight, not just your arm strength. For an adult, current guidance calls for a compression depth of at least 2 inches, though not so deep that you cause unnecessary injury beyond what is expected in a resuscitation effort. Shallow compressions are one of the most common mistakes lay rescuers make, often because they are afraid of hurting the person. Some rib injury is a normal and acceptable trade-off for effective CPR; a broken rib is far preferable to a preventable death.
Aim for a compression rate of 100 to 120 per minute. This is faster than most people instinctively push. A widely taught reference point is the tempo of the song "Stayin' Alive" by the Bee Gees, which happens to fall right in that range and gives rescuers a mental rhythm to follow. Compressing too slowly reduces blood flow to the brain and heart; compressing too fast often sacrifices depth and control.
Just as important as pushing down is allowing the chest to fully recoil, meaning it returns to its normal position between each compression. Full chest recoil lets the heart refill with blood before the next compression pushes it back out. Leaning on the chest between compressions, even slightly, prevents this refill and reduces the effectiveness of your efforts. Keep your hands in contact with the chest, but consciously release pressure fully after each push.
Minimize interruptions. Every pause in compressions, whether to check on the person, reposition, or catch your breath, reduces blood flow that has to be rebuilt once compressions resume. Try to keep any interruption under 10 seconds. If you tire, and you likely will within two minutes even if you are in good physical condition, this is where a second rescuer becomes valuable, a topic covered later in this guide. Until help arrives or another trained person is available, continue compressions steadily rather than stopping and starting repeatedly.
Step 5: Give Rescue Breaths (If Trained)
If you are trained in CPR and comfortable doing so, current guidance for adults uses a ratio of 30 compressions to 2 breaths. This means after every 30 chest compressions, you pause briefly to deliver two rescue breaths before returning to compressions. This compression-to-ventilation ratio balances circulating blood with restoring oxygen levels, which matters more in situations like drowning or drug overdose where oxygen depletion is often the primary problem rather than a sudden heart rhythm disturbance.
To give a rescue breath, tilt the person's head back slightly and lift their chin to open the airway, then pinch their nose shut. Make a complete seal over their mouth with yours and give one breath over about one second, watching for the chest to visibly rise. Give a second breath the same way. If the chest does not rise, reposition the head and try again before returning to compressions; do not spend excessive time adjusting.
If you are untrained, uncomfortable giving breaths, or unable to form a proper seal, hands-only CPR is an accepted and effective alternative for adult cardiac arrest. This approach, consisting of continuous chest compressions without pauses for breaths, is specifically endorsed for bystanders who have not completed formal training or who are hesitant about rescue breathing. Adults in cardiac arrest typically have enough oxygen already in their blood for the first several minutes, so continuous compressions that keep that blood circulating can be lifesaving on their own. Do not let uncertainty about rescue breaths stop you from starting compressions; something is almost always better than nothing.
Step 6: Use an AED as Soon as It Arrives
When the AED arrives, turn it on immediately. Nearly all models begin giving voice prompts as soon as they power on, walking you through each step aloud. Follow these prompts even if you have used an AED before, since minor differences exist between models.
Attach the pads to the person's bare, dry skin exactly as shown in the diagram printed on the pads themselves, typically one below the right collarbone and one on the lower left side of the chest. If the chest is wet from sweat or water, quickly wipe it dry first so the pads adhere properly and deliver an accurate reading. If the person has a heavy amount of chest hair blocking pad contact, some AED kits include a razor for quick removal.
Once the pads are connected, the AED will begin analyzing the heart rhythm. Stand clear and make sure no one is touching the person during this analysis, as movement can interfere with the reading. If the device advises a shock, loudly announce that everyone should stand clear, confirm no one is in contact with the person, and press the shock button if the AED requires manual activation. Immediately after the shock, or if no shock is advised, resume chest compressions right away rather than pausing to check for signs of life.
Continue cycling between CPR and AED analysis according to the device's prompts, typically every two minutes, until the person begins showing signs of life such as movement or normal breathing, or until EMS personnel arrive and take over care.
Step 7: Continue Until Help Arrives or the Person Recovers
CPR is physically demanding, and compression quality noticeably declines after about two minutes of continuous effort, even among fit and trained rescuers. If another trained person is present, switch who is performing compressions every two minutes, coordinating the change so the pause in compressions lasts only a few seconds. Communicate clearly, such as counting down "switching in three, two, one," to keep the transition smooth.
While continuing CPR, watch for signs that the person is recovering: normal breathing returning, coughing, opening their eyes, or purposeful movement. If these signs appear, stop compressions and reassess breathing. If the person is breathing normally but still unresponsive, position them on their side in the recovery position and continue monitoring until EMS arrives.
When EMS personnel arrive on scene, be ready to hand off care with a concise summary: when the person collapsed, how long you performed CPR, whether an AED delivered any shocks, and any relevant medical history you know of, such as a known heart condition or recent complaints of chest pain. This information helps the incoming medical team make faster, better-informed decisions.
Do not stop CPR on your own judgment simply because it feels like a long time has passed. Continue until EMS takes over, an AED indicates a shock is no longer advised and the person shows signs of life, or you are physically unable to continue.
Building Confidence Beyond This Guide
Knowing these steps can help you act quickly in an emergency, but hands-on practice through a certified course, such as those offered by Midwest CPR Center, builds the muscle memory and confidence needed to perform CPR correctly under pressure. Reading about compression depth, hand placement, and rescue breath technique is a useful starting point, but skills like these are difficult to fully internalize from text alone. Certified courses in CPR, First Aid, AED use, and Basic Life Support give you supervised practice on training manikins, feedback on your technique, and the chance to work through realistic scenarios before you ever need these skills in real life.
Don't wait until an emergency happens, equip yourself and your team with life-saving skills today. Schedule your CPR certification class now and gain the confidence to respond when every second counts.