Objectives Actions
Adult (>8) Child (1-8) Infant (<1)
A. Airway 1. Assessment: Determine unresponsiveness. Tap or gently shake shoulder.
Say, "Are you okay?" Observe
2. Get help. Call out "Help!"
3. Position the victim. Turn on back as a unit, supporting head and neck if necessary. (4-10 seconds)
4. Open the airway. Head-tilt/chin-lift (child image)and possibly Jaw Thrust if necessary
B. Breathing 5. Assessment: Determine breathlessness. Maintain open airway. Place ear over mouth, observing chest. Look, listen, feel for breathing. (3-5 seconds)
6. Give 2 rescue breaths. Maintain open airway.
Seal mouth to mouth. Mouth to nose/mouth
Give 2 rescue breaths, 1 to 1.5 seconds per inflation. Observe chest rise. Allow lung deflation between breaths.
7. Option for obstructed airway. a. Reposition victim's head. Try again to give rescue breaths.
b. Activate the EMS system.
c. Give 6-10 subdiaphragmatic abdominal thrusts (the Heimlich maneuver). Give 4 back blows.
Give 4 chest thrusts.
d. Tongue-jaw lift and finger sweep Tongue-jaw lift, but finger sweep only if you see a foreign object.
e. If unsuccessful, repeat a, c, and d until successful.
C. Circulation 8. Assessment: Determine pulselessness. Feel for carotid pulse with one hand; maintain head-tilt with the other (5-10 seconds)

For two-rescuer CPR, one person assesses while other rescuer assumes proper position for external chest compressions.

Feel for brachial pulse; keep head-tilt.
9. Activate EMS system. If someone responded to call for help, send them to activate the EMS system.
Begin chest compressions:
  1. Landmark check
  2. Hand position
  3. Rescuer position
  4. Compression rate
Run middle finger along bottom edge of rib cage to notch at center (tip of sternum). Imagine a line drawn between the nipples.
Place index finger next to finger on notch: Place 2-3 fingers on a sternum, 1 finger's width below line. Depress .5-1 inch. For neonate use chest encirclement technique and depress .5-.75 inch.
Two hands next to index finger. Depress 1.5-2 inches. Heel of one hand next to index finger. Depress 1-1.5 inches.
80-100 per minute. At least 100 per minute.
CPR Cycles 13. Compressions to breaths. 2 breaths to every 15 compressions

For Two-rescuer CPR, 5 compressions to one breath exchanging positions if nessary.

1 breath to every 5 compressions
14. Number of cycles. 4 (52-73 seconds) 10 (60-87 seconds) 10 (45 seconds or less)
15. Reassessment. Feel for carotid pulse. (5 seconds) Feel for brachial uplse.
If no pulse, resume CPR, starting with 2 breaths. If no pulse, resume CPR, starting with 1 breath.
Option for entrance of 2nd rescuer 1st rescuer ends CPR. End cycle with 2 rescue breaths. End cycle with 1 rescue breath.
2nd rescuer checks pulse (5 seconds). Feel for carotid pulse. Feel for brachial pulse.
If no pulse, 2nd rescuer begins CPR. Begin one-rescuer CPR, starting with 2 breaths. Begin one-rescuer CPR, starting with 1 breath.
1st rescuer monitors 2nd rescuer. Watch for chest rise and fall during rescue breathing; check pulse during chest compressions.
Option for pulse return If no breathing, give rescue breaths. 1 breath every 5 seconds 1 breath every 4 seconds 1 breath every 3 seconds