Adult Cardiopulmonary Resuscitation Guidelines

Basic Life Support

The American Heart Association recommends that all rescuers should provide chest compressions for victims of cardiac arrest, with a compression depth of 5-6 cm at a rate of 100-120 compressions per minute, allowing for complete chest recoil between compressions 1, 2, 3
Check for responsiveness by shouting and tapping the victim, and if unresponsive, activate emergency response system and get an AED (or send someone to do so) 4, 5
Look for no breathing or only gasping and check pulse simultaneously (within 10 seconds) 6
Begin CPR immediately with chest compressions if no pulse is detected within 10 seconds, and perform cycles of 30 compressions followed by 2 breaths 4, 7, 8
Use the AED as soon as it becomes available 9
Untrained rescuers should provide compression-only CPR, while trained rescuers may provide ventilation (rescue breaths) in addition to compressions 1, 10
After identifying cardiac arrest, a lone responder should activate emergency response system first, then begin CPR 2

Check rhythm every 2 minutes, and for shockable rhythms (VF/pVT), deliver shock immediately and resume CPR for 2 minutes before reassessing rhythm 5
Establish IV/IO access, and administer epinephrine every 3-5 minutes, considering amiodarone or lidocaine for refractory VF/pVT 5, 7

For victims with a pulse but no normal breathing, provide rescue breathing at a rate of 1 breath every 6 seconds (10 breaths/minute), and check pulse every 2 minutes 6
For suspected opioid overdose, administer naloxone if available 6

Healthcare providers often take too long to check for a pulse, leading to delays in starting compressions, and minimizing pauses in chest compressions is critical for survival 10
Incomplete chest recoil prevents full cardiac refilling, and allowing complete chest recoil between compressions is essential 7