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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medically reviewed by WellAlly Editorial TeamLast reviewed October 19, 2026Editorial policy
First Aid18 min read

How to Perform Hands-Only CPR During a Cardiac Arrest

Published: October 19, 2026Updated: October 19, 2026

Hands-only cardiopulmonary resuscitation (CPR) is an emergency intervention performed when an adult suddenly collapses and stops breathing normally. By delivering continuous, high-quality chest compressions without rescue breaths, you help maintain vital blood flow to the brain and heart. Acting immediately during an out-of-hospital cardiac arrest can double or triple a person's chance of survival.

Quick Summary

If an adult collapses and is unresponsive and not breathing normally, call 911 immediately and push hard and fast in the center of their chest until professional help arrives.

Important Medical Disclaimer

This guide is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with qualified healthcare providers for medical concerns.

Step-by-Step Guide

1

Check the Scene and Assess Responsiveness

First, ensure the immediate environment is safe for both you and the victim. Kneel beside the person, tap their shoulder firmly, and loudly ask, 'Are you okay?' Look quickly at their chest and face for signs of normal breathing, taking no more than 10 seconds to assess.

Important: Occasional gasping, snorting, or agonal breathing is not normal breathing; it is a sign of cardiac arrest and requires immediate CPR.

2

Call 911 and Get an AED

If the person does not respond and is not breathing or only gasping, immediately call 911 or your local emergency number. If bystanders are present, point directly to a specific person and instruct them to call 911 and locate an automated external defibrillator (AED). If you are alone, put your phone on speaker mode while you begin compressions immediately.

3

Position the Person and Yourself

Place the person flat on their back on a firm, flat surface such as the floor or ground; avoid performing CPR on a soft mattress or couch. Kneel beside the person's chest with your knees hip-width apart for balance. Expose the person's bare chest if possible to ensure accurate hand placement.

4

Place Your Hands in the Center of the Chest

Place the heel of one hand directly on the center of the person's chest, along the lower half of the breastbone. Place your other hand on top of the first and interlock your fingers, keeping your fingers pulled up off the ribcage. Straighten your arms and lock your elbows so your shoulders are positioned directly over your hands.

Important: Do not press on the ribs or the very bottom tip of the breastbone, as this can increase the risk of internal injury.

5

Deliver Hard and Fast Chest Compressions

Push straight down using your upper body weight, compressing the chest at least 2 inches (5 cm) deep but no more than 2.4 inches (6 cm). Compress at a steady rhythm of 100 to 120 beats per minute, which matches the beat of the song 'Stayin' Alive'. Allow the chest to rise completely back to its normal position between every single compression.

Important: Avoid leaning on the chest between compressions, because full chest recoil is required for the heart to refill with blood.

6

Continue Until Help Arrives or an AED Is Ready

Do not interrupt compressions for more than a few seconds. If an AED arrives, turn it on immediately and follow the automated voice prompts while continuing CPR until the device is ready to analyze. If another bystander is available, switch compressors every two minutes to prevent fatigue and keep compressions effective.

Frequently Asked Questions

Can I harm someone by performing CPR if their heart hasn't completely stopped?
The risk of causing serious harm by performing chest compressions on someone who is unresponsive is extremely low, whereas the risk of not performing CPR during cardiac arrest is fatal. Always start CPR if the person is unresponsive and not breathing normally.
Why are rescue breaths no longer required for bystander CPR?
During the first few minutes of sudden cardiac arrest, the person's blood still contains residual oxygen. Continuous chest compressions keep this oxygen-rich blood circulating to the brain and heart without interruption, and studies show hands-only CPR is just as effective as conventional CPR for adult out-of-hospital arrests.
What should I do if I feel or hear ribs crack during compressions?
It is common to hear cracking or feel cartilage pop during effective chest compressions, particularly in older adults. Do not stop or reduce compression depth; a fractured rib can heal, but cardiac arrest without effective blood flow is fatal.
Does hands-only CPR apply to infants and children?
No. Cardiac arrest in infants and young children is most often caused by respiratory failure rather than sudden cardiac arrhythmia. For children and drowning victims, conventional CPR with both chest compressions and rescue breaths (30 compressions to 2 breaths) is strongly recommended.
  1. 1
    CDCSource
  2. 2
    Mayo ClinicSource
  3. 3
    NHSSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed October 19, 2026. · Read our editorial policy