Cardiac arrest happens when the heart stops pumping blood effectively. It is different from a heart attack, which is a blocked artery, though a heart attack can trigger one. This guide shows you how to perform Hands-Only CPR, meaning chest compressions without rescue breaths, on an adult who has collapsed and is not breathing normally. You will learn the actions in order and how to do each one correctly. You need no equipment and no prior training, though practice in a certified course builds the confidence to act under stress. The steps below cover the core sequence plus a final step on when this method is not enough.
Step 1: Check the Scene and the Person
Before you move toward the person, look around for hazards: moving traffic, fire or smoke, downed power lines, water near electrical equipment, or an unstable structure. If the scene is unsafe, stay back and call for help. You cannot help anyone if you become a second victim. Moving the person is rarely necessary, so only do it if they are in immediate danger.
Once the area is safe, kneel beside the person and tap their shoulders firmly while shouting, "Are you OK?" Do not shake them hard. You are checking for any purposeful response, such as speaking, moving, or opening their eyes.
Then look at the chest and face for no more than about 10 seconds. Treat this as cardiac arrest if the person is:
- unresponsive and not breathing, or
- unresponsive and only gasping.
That second case matters. Gasping, often called agonal breathing, is an irregular, snorting, or gulping reflex that can occur in the first minutes after the heart stops. It is not effective breathing and does not deliver useful oxygen. Many bystanders see gasping, assume the person is still breathing, and wait. That hesitation costs time the person does not have.
If you are unsure whether the breathing is normal, act as though it is not. Starting compressions on someone who turns out not to need them is a far smaller error than withholding them from someone who does.
Step 2: Call 911 and Send Someone for an AED
If other people are nearby, do not shout a general request and hope someone responds. Point at a specific person and give a direct instruction: "You in the blue jacket, call 911 and tell them an adult is unresponsive and not breathing." Then point at someone else: "You, find an AED and bring it back here." Named, pointed instructions get acted on, while a vague cry for help often gets ignored because everyone assumes someone else has it covered.
If you are alone, call 911 yourself and put the phone on speaker. Set it down next to the person's head or chest so both your hands are free. Do not hang up to start compressions, and do not go searching for an AED if you are the only rescuer and none is in sight. Compressions come first.
The dispatcher is a resource, not just a switchboard. Emergency dispatchers are trained to coach callers through Hands-Only CPR in real time, including counting and pacing. Answer their questions briefly, give the exact location, and stay on the line until they tell you it is fine to hang up or until responders arrive and take over.
An AED, or automated external defibrillator, is the other half of the survival equation. Compressions keep blood moving to the brain and heart, but only a shock from a defibrillator can reset certain dangerous heart rhythms. Step 6 covers how to use one.
Step 3: Position the Person and Your Body
Effective compressions need a firm, flat surface underneath the person. If they are face down or on their side, roll them onto their back as a unit, keeping the head, neck, and torso moving together as much as you can. Extend their arms alongside the body.
If the person has collapsed on a bed, sofa, or other soft surface, slide or lower them to the floor. A soft surface absorbs the force of your pushes, so the chest does not compress deeply enough to move blood. On a hard floor, the same effort goes where it should.
Kneel beside the person's chest with your knees about shoulder-width apart. This stable base lets you lean over them and use your body weight rather than just your arms. If you are kneeling too far from the chest, you will tire faster and lose depth.
One mistake to avoid is spending time on positioning that does not help. Do not place the person in the recovery position, which is for people who are breathing normally. Do not fetch a pillow for their head or spend time straightening limbs. Those steps feel caring, but every few seconds without compressions reduces the chance of survival. Get them flat and firm, get your body in place, and move on.
Step 4: Place Your Hands in the Right Spot
Find the center of the chest, on the lower half of the breastbone (sternum). For most adults, this is roughly between the nipples, but use the breastbone as your guide rather than a fixed measurement. Place the heel of one hand there, which is the firm, bony part of your palm closest to your wrist.
Put your other hand on top of the first. You can interlace your fingers or keep them lifted, whichever is more comfortable, as long as your fingers stay off the ribs. Pressure should travel through the heel of your hand into the breastbone, not into the sides of the chest.
Then set your body:
- Straighten and lock your elbows.
- Bring your shoulders directly over your hands, so your arms form a vertical line to the chest.
- Plan to push by hinging at the hips, using your upper body weight rather than the strength of your arms alone.
Clothing is a common point of hesitation. Moving bulky items such as a heavy coat or thick sweater aside is reasonable, and you can compress through thin clothing. Do not waste time undressing the person. Once an AED arrives, the chest will need to be bare for the pads, so you can remove clothing then.
Body size changes things only slightly. On a smaller adult you may need a little less force to reach the right depth, and on a larger adult a bit more. The same hand position applies. Technique for children and infants differs, including hand placement and depth, so learn it in a hands-on course rather than guessing from this guide.
Step 5: Push Hard and Fast at the Right Rate and Depth
Begin compressions right away. Push straight down on the chest, then release fully, and repeat without stopping to give breaths.
Rate and depth
The American Heart Association (AHA) recommends a rate of 100 to 120 compressions per minute. A common memory aid is the beat of the Bee Gees song "Stayin' Alive," which falls in that tempo range and is widely cited by the AHA for this purpose. Dispatchers may also count aloud for you.
For adults, the AHA recommends compressing at least 2 inches (about 5 cm) but not more than about 2.4 inches (6 cm). In practice, most untrained rescuers push too shallow, so err toward pushing harder. Guidelines are updated periodically, so confirm current figures with the AHA as of 2026.
Recoil, pauses, and fatigue
Let the chest return fully to its normal position between pushes. This is called chest recoil, and it allows the heart to refill with blood. Do not lean on the chest or rest your weight on it between compressions.
Keep interruptions as short as possible. Compressing is tiring, and effectiveness drops noticeably after a couple of minutes. If another person is present, switch about every 2 minutes, and make the swap quickly, in under a few seconds.
Ribs and legal worries
You may feel or hear ribs crack. This can happen even when compressions are done correctly, and it should not stop you. Rib injuries heal, while cardiac arrest without circulation is fatal. Most U.S. states have Good Samaritan laws that protect people who help in good faith in an emergency, but the details vary, so check the law in your state if you have concerns.
Step 6: Use an AED as Soon as It Arrives, and Keep Going Until Help Takes Over
When an AED arrives, turn it on and follow its voice prompts. Most models speak step by step and show diagrams. Bare the chest, dry it if it is wet, and apply the pads exactly as pictured, usually one on the upper right chest and one on the lower left side. If a second person is available, keep compressing while they attach the pads and power on the device.
The AED will analyze the heart rhythm. When it says so, stop touching the person and make sure no one else is touching them. If a shock is advised, the machine will tell you when to press the shock button (some deliver it automatically). Resume compressions immediately afterward, without waiting to check for a pulse, and follow the device's prompts for the next analysis.
AEDs are designed for untrained bystanders. The device decides whether a shock is needed, and it will not deliver one unless it detects a rhythm that requires it. You cannot shock someone by mistake in a way that harms them.
Continue until one of the following happens:
- Emergency medical services (EMS) take over.
- The person clearly wakes up and breathes normally.
- An AED advises that you stop or otherwise directs you.
- You are too exhausted to continue and no one can relieve you.
- The scene becomes unsafe.
Do not stop to check for a pulse yourself. Untrained rescuers often cannot judge it reliably, and the pause costs time.
Step 7: Know When Hands-Only CPR Is Not Enough
Hands-Only CPR is recommended for adults and teens who suddenly collapse, particularly in out-of-hospital settings where the heart's problem is usually the primary cause. In those cases, the blood already contains oxygen, and compressions circulate it.
Conventional CPR with rescue breaths is preferred when the cause is likely related to breathing or oxygen, including:
- children and infants
- drowning
- drug overdose
- other breathing-related emergencies
If you have been trained to give breaths and are willing, use them in these situations. If you are not trained, Hands-Only CPR is still far better than doing nothing.
Healthcare providers and childcare workers usually need more than the layperson method. Employers and licensing bodies often require Basic Life Support (BLS) certification or CPR that includes rescue breaths, along with team-based skills and child and infant techniques. Check what your workplace or license requires.
The practical next step is a course with manikin practice and an instructor who corrects your depth, rate, and hand position. Midwest CPR Center offers CPR, AED, and BLS courses that provide both skills and certification. You do not need a certificate to help in an emergency, but training makes the steps automatic. Guideline details are revised from time to time, so check current AHA or American Red Cross guidance for updates.
Practice the Sequence Before You Need It
The six actions are: check the scene and person, call 911 and send for an AED, position the person and yourself, place your hands, compress hard and fast, and use the AED until help takes over. Reading them once is a start. Saying them aloud, walking through them with a friend, and practicing on a manikin under an instructor's eye is what makes them reliable when adrenaline is high.
Also take a minute this week to find the nearest AED at home, at work, and at your child's school or your place of worship. Knowing where it is saves the minutes you would otherwise spend searching.
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.