Why Adult CPR Matters at Home

Around four out of five cardiac arrests that happen outside hospital take place in the home. That means the person who is most likely to need CPR is someone you love, in a room you know well. Starting chest compressions quickly can double or even triple the chance of survival, and every minute without them reduces those odds by roughly a tenth.

Ambulance crews in the UK are fast, but they cannot be everywhere at once. The few minutes between collapse and their arrival belong to whoever is standing nearby. This guide covers adult CPR only — children and infants need a different approach, so ask the 999 call handler for guidance if you are unsure.

Step One: Check for Danger and Response

Before you touch anyone, look around. Traffic, water, electricity, fire, fumes or an aggressive dog can quickly turn one casualty into two. You are no use to anyone if you become the next patient, so make the scene safe first.

• Kneel beside the person and tap their shoulders firmly.
• Shout clearly: "Are you all right?"
• If there is no response, open the airway by tilting the head back gently and lifting the chin.
• Spend no more than ten seconds checking for normal breathing — look for chest movement, listen at the mouth, and feel for breath on your cheek.

Occasional slow, noisy gasps are not normal breathing. They are common in the first minutes of a cardiac arrest and should be treated as if the person is not breathing at all.

Step Two: Call 999 and Ask for a Defibrillator

If the person is unresponsive and not breathing normally, call 999 immediately. Put your phone on speakerphone so you can keep both hands free, and say plainly: "Someone is not breathing and we are starting CPR." The call handler will stay with you and coach you through every compression if you need it.

If anyone else is present, send them to fetch the nearest public access defibrillator. These are increasingly found at community centres, shops, sports clubs and phone boxes, and they are designed for untrained members of the public to use. If you are on your own, do not leave the casualty to search — stay with them and keep compressing.

Step Three: Chest Compressions, Step by Step

• Lay the person flat on their back on a firm surface — the floor is ideal, not a sofa or bed.
• Kneel beside them, level with their chest.
• Place the heel of one hand in the centre of the chest, on the middle of the breastbone. Put your other hand on top and interlock your fingers, keeping them clear of the ribs.
• Keep your arms straight and your shoulders directly above your hands, then press down firmly.
• Push down by 5 to 6 centimetres — roughly a third of the depth of the chest — then release fully without losing contact with the skin.
• Aim for 100 to 120 compressions per minute, which is about two per second. The beat of "Stayin' Alive" is a handy guide.

Compressions are physically demanding. If someone else is with you, swap over every two minutes so you both stay effective. Do not worry about breaking ribs — a cracked rib can heal, but a stopped heart cannot wait.

Step Four: Rescue Breaths — or Hands-Only CPR

If you are trained, confident and willing, give two rescue breaths after every 30 compressions. Open the airway with a head tilt and chin lift, pinch the nose closed, seal your mouth around theirs and blow steadily for about one second, watching for the chest to rise. Then return to compressions straight away. The ratio is 30 compressions to 2 breaths.

If you are unwilling or unable to give breaths, do hands-only CPR: continuous compressions at 100 to 120 per minute. Hands-only CPR is far better than doing nothing, and it is exactly what most UK ambulance services will talk you through over the phone. Use a pocket mask or face shield if you have one to hand.

Using a Defibrillator and Knowing When to Stop

When the defibrillator arrives, switch it on and follow the voice prompts. Bare the chest, attach the pads as shown on the pictures — typically one below the right collarbone and one on the left side beneath the armpit — make sure nobody is touching the person while it analyses, then deliver a shock if instructed and resume compressions immediately.

Keep going until the ambulance crew take over, until the person wakes and breathes normally, or until you are physically exhausted. If they do start breathing again, roll them into the recovery position on their side, keep them warm and monitor their breathing until help arrives.

Practice Makes Preparedness

CPR skills fade surprisingly quickly, so a short refresher every year or so is well worth the time. A basic first aid kit, a written note of where your nearest defibrillator lives, and a quick run-through with everyone in the household — including teenagers — can make all the difference on the day it matters.

You cannot get this wrong by trying. Even imperfect compressions are dramatically better than none, and the calm voice on the other end of the 999 call will guide you through each step until the professionals arrive.