CPR in Adults

Youth Heart Watch demonstrates how to respond and perform cardiopulmonary resuscitation (CPR) on an adult who is experiencing a sudden cardiac arrest (SCA). Learn CPR to help save the life of a family member, friend, or even a stranger.


CPR in Adults

Victoria Vetter, MD, FAAP, FACC: Hello, my name is Dr. Victoria Vetter and I'm a pediatric cardiologist and the Director of Youth Heart Watch at the Children's Hospital of Philadelphia. This video will demonstrate how to perform CPR and use an AED on an adult when a sudden cardiac arrest occurs. CPR stands for cardiopulmonary resuscitation and is done by pushing hard and fast in the center of the chest.

CPR helps to manually push blood through a person's body when their heart has stopped beating.

An automated external defibrillator or AED is a device that reads a person's heart rhythm and can shock or reset the heart to a normal rhythm. Prompt CPR and use of an AED can help save a person's life before EMS arrives.

CPR should be performed when someone is unresponsive, not breathing or not breathing normally, with gasping or agonal breathing.

Scene safety. First, if an adult is unresponsive and you suspect a cardiac arrest, assess the scene.

Man: Are you okay?

Victoria Vetter, MD, FAAP, FACC: Check for responsiveness. When you know you are safe, tap the victim and shout to check their responsiveness.

Man: Are you okay?

Victoria Vetter, MD, FAAP, FACC: Alert EMS. Call 911. If the person is unresponsive, tell someone to call 911 and retrieve an AED immediately if one is available. If you are alone, call 911 yourself and get the AED. If you are alone and then AED is unavailable, put the phone on speaker so you have two hands to help the victim.

Pulse and breathing check. For lay or bystander rescuers, pulse and breathing check is no longer recommended.

For healthcare providers, check for breathing and a pulse. Check in the neck for the carotid pulse and check to see if they are breathing. If the person is not breathing, or not breathing normally or gasping for breath, begin CPR. You'll want to make sure the person is face up on a hard flat surface. If they are on a bed or other cushioned area, you should move them to the floor.

Begin hands-only or compression-only CPR. Put the heel of one hand over the lower end of the breast bone in the center of the chest at the nipple line. Cover with your other hand and interlock your fingers. Straighten your arms and lock your elbows so that your body weight is over your hands. Push straight down at a rate of 100 to 120 beats per minute at a depth of two inches, about one third the depth of the chest.

Make sure you are not leaning on the chest and you're allowing the chest to recoil or expand completely after each compression. Count out loud when doing the compressions, it should look and sound like this.

Man: 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30.

Victoria Vetter, MD, FAAP, FACC: AED use. Using an AED is quite simple. Although every AED is slightly different, they are all made to be user-friendly and walk you through the steps. Once the AED is on the scene, you will open the unit, turn it on, and immediately begin attaching it to the victim. Then following the images or instructions, put the pads on the victim's bare chest, placing one over the right side of the victim's chest, just below the collarbone. And the other on the lower left side of the chest.

The pads are placed in these positions to deliver a shock across the heart. If the victim has a pacemaker, implantable cardiac defibrillator or medical patch that you can see, avoid placing the pads directly over these items. If there is hair on the chest in the area of the pad placement, it will need to be quickly shaved with a razor in the safety kit attached to the AED.

Continue CPR until the AED tells you to stop while it analyzes the heart rhythm.

AED: Do not touch patient. Analyzing rhythm.

Victoria Vetter, MD, FAAP, FACC: If a shock is advised, the AED will tell you to stand clear and either press the shock button or shock will be automatically delivered by the unit, and you'll begin CPR again. If a shock is not advised, the unit will tell you to continue chest compressions.

Continue CPR and following the AED voice instructions until EMS arrives or until the victim regains consciousness. Do not remove the pads from the victim because they might suffer another arrest before help arrives and need to be shocked again.

Compression breath ratio. If the victim is a drowning victim, you will need to provide rescue breaths.

Perform 30 compressions, followed by two breaths, and repeat this cycle.

Let's review the steps of adult CPR and AED use again. First, assess the scene and check for responsiveness. Next, call 911 and get an AED if available. Pulse and breathing check. For lay or bystander rescuers, pulse and breathing check is no longer recommended. For healthcare providers, check for breathing and if they have a pulse.

If not, begin hands-only CPR and use the AED once it arrives. Continue CPR and follow AED instructions until EMS arrives.

Related Centers and Programs: Youth Heart Watch