Cardiac arrest can happen anywhere, at home, work, or even in a public place. You can save the victim’s life easily by providing them with cardiopulmonary resuscitation (CPR) before emergency medical services (EMS) arrive. Unfortunately, over 70% of out-of-hospital cardiac arrests happen at home, according to the American Heart Association (AHA).
The best course of action during this time is to use hands-only CPR to save the person. This key technique focuses solely on chest compressions without mouth-to-mouth breathing. It’s also quick to learn, easy to perform, and highly effective during the critical moments before professional medical help arrives. In this guide, we will explore what hands on CPR means, why it’s recommended, and the exact steps to perform it.
What is Hands-Only CPR?
Hands-only, or compressions-only CPR, is a form of cardiopulmonary resuscitation that uses only chest compressions to keep blood circulating in a person’s body during cardiac arrest. During this time, the heart stops beating effectively, and the blood stops carrying oxygen to the brain. In the worst cases, permanent brain damage or death can occur within minutes.
The CPR method allows you to manually pump blood through their body. This buys you enough time to maintain blood circulation until emergency responders arrive. Uninterrupted chest compressions can easily help you maintain blood flow and improve survival rates. This is beneficial, especially in the first few minutes after cardiac arrest.
This hands-only method of CPR is quite different from traditional CPR, as showcased in the table below:
| Feature | Traditional CPR | Hands-Only CPR |
| Involves rescue breaths | Yes (mouth-to-mouth) | No, chest compressions only |
| Recommended for | Adults, children, and infants (with modifications) | Teenagers and adults in sudden cardiac arrest |
| Rescue breath ratio | 30 compressions + 2 breaths | Continuous compressions (100–120 per minute) |
| Training requirements | Recommended but more complex | Easier to learn and remember |
| Primary benefit | Provides both oxygen and circulation | Maintains blood circulation until help arrives |
Please note that hands-only CPR is not suitable for children under 8 or for drowning victims. In such situations, rescue breaths can help you resuscitate the victims.
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Is Hands-Only CPR Still Recommended?
Yes. The AHA usually recommends the hands-only method for untrained bystanders or those hesitant to perform mouth-to-mouth resuscitation. Studies even show that CPR doubles or triples the chances of survival after cardiac arrest. The hands-only CPR method is particularly recommended for adults and teens who collapse suddenly and in situations where the rescuer is not confident in giving rescue breaths. Sometimes, it is also helpful in public emergencies where time is critical and equipment is limited.
It is not recommended as the only method for infants and small children, victims of drowning, and people with respiratory arrest caused by choking, drug overdose, or asthma. Traditional CPR with rescue breaths is the best way to save lives in these cases. Moreover, mouth-to-mouth resuscitation is still necessary for pediatric CPR, not just traditional CPR.
What is the Correct Procedure for Hands-Only CPR?
The correct procedure for hands-only CPR is to place the heel of one hand on the center of the victim’s chest with the other hand on top, fingers interlocked. Make sure to keep the following things in mind when conducting the procedure:
Assess the Situation
Make sure you are not at risk before approaching the victim. Gently tap or shout to see if the person responds. Always call for help before starting compressions, or enlist someone nearby to do so. Sometimes, agonal breathing can be mistaken for normal breathing. So, you should be more cautious when attending to victims in emergencies.
Hand Placement
Place the heel of one hand on the centre of the person’s chest, specifically on the lower half of the sternum. Put your other hand on top and interlock your fingers so they are lifted off the chest to avoid pressure on the ribs. For individuals with implanted devices (e.g., pacemakers), avoid placing hands directly over the device. It is often felt in the left upper chest ( as a hard lump).
Body Position
Position yourself so your shoulders are directly above your hands, with elbows locked. Keep your body steady to maintain consistent depth and rhythm. For very large-bodied or frail individuals, you may need to adjust the position for effective compressions.
Compressions
You must press down at least 2 inches (5 cm) for adults at a rate of 100–120 compressions per minute. A steady rhythm similar to that of the beat of “Stayin’ Alive” by the Bee Gees helps maintain blood flow to key organs until help arrives.
Note: For pregnant individuals, slightly position hands above the usual spot or at the center, and tilt the patient onto the left side to relieve vena cava compression if possible. For individuals with osteoporosis or suspected rib fractures, still perform compressions, as broken ribs are less harmful than inadequate blood circulation.
Chest Recoil
Allow the chest to fully return to its normal position before pushing again after each compression. This recoil lets the heart refill with blood, which helps with better circulation. Avoid leaning on the chest between compressions because it reduces the effectiveness of CPR. If a cracking sound is heard, continue with the compressions because such occurrences are quite common and do not require you to stop the CPR.
Continue
Keep performing compressions without any breaks until trained medical help arrives or an AED is ready to be used. If the person starts breathing normally, you may stop, but continue to monitor their condition. Remember, consistent, uninterrupted compressions greatly improve the chances of survival. If alone and you must leave to get help or an AED, do so only if absolutely necessary. If the person vomits, turn them on their side and clear the airway only if safe to do so.
Special Scenarios
- Children and Infants: Use one hand for compressions (children) or two fingers (infants), compress the chest about 1/3 depth (approx. 2 inches for children, 1.5 inches for infants). Infants generally require rescue breaths at a 30:2 ratio, especially in the presence of a single rescuer.
- Drowning Victims: If possible, start rescue breaths if trained, after removing them from water.
- Suspected Trauma: Still perform compressions if unconscious and not breathing—CPR takes priority.
- Opioid Overdose: If available and trained, give naloxone before or during CPR. Please note that chest compressions should never be delayed while searching for naloxone.
When performing hands-only CPR, you must keep the following things in mind:
| Category | Guideline |
| Depth | Push at least 2 inches deep for adults |
| Rate | Maintain 100–120 compressions per minute |
| Consistency | Avoid pauses; continuous compressions are crucial |
| Recoil | Let the chest fully return to its normal position between pushes |
Why is Mouth-to-Mouth No Longer Recommended?
Mouth-to-mouth is not entirely eliminated from CPR guidelines. Even now, AHA emphasizes simplicity for untrained bystanders. However, it’s no longer the default recommendation for untrained bystanders in adult sudden cardiac arrest. Reasons for this change include:
- Public Hesitation: Infection concerns, especially during outbreaks of transmissible diseases (e.g., COVID-19, flu), reinforce reluctance for mouth-to-mouth. Sometimes, bystanders may also worry about legal risks.
- Cardiac Arrest vs. Respiratory Arrest: The majority of adult cardiac arrests happen due to heart-related problems rather than breathing issues. Chest compressions alone can circulate this oxygen-rich blood to the brain and heart in these cases.
- Simplification: CPR can be intimidating, especially if the person has not been trained. If someone needs rescue breaths also at this time, the situation increases in complexity.
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What are the Key Hands-Only CPR Steps?
Knowing only the CPR steps is not enough to save the life of a person, especially if they suffer from any cardiovascular disease or respiratory issues. This requires you to follow specific steps, such as:
| Step | What to Do | Why It Matters |
| Check Responsiveness and Breathing | Tap the person’s shoulder and shout, “Are you okay?” Look for normal breathing, not gasping or occasional agonal breaths. | Confirms cardiac arrest and prevents delay. |
| Call Emergency Services (911) | Dial 911 or ask someone nearby to call. Request an AED if one is available. Follow dispatcher instructions. | Early activation of emergency help improves survival. |
| Position Your Hands Correctly | Place the heel of one hand on the center of the chest (lower half of sternum), the other hand on top. Keep elbows straight and shoulders over hands. | Ensures full, effective compressions. |
| Start Chest Compressions | Push hard and fast, at least 2 inches (5 cm) deep, 100–120 per minute — similar to the beat of “Stayin’ Alive.” | Maintains blood flow to vital organs. |
| Continue Until Help Arrives | Don’t stop unless the person starts breathing, trained rescuers take over, or you are physically unable to continue. Use an AED immediately if available. | Every minute without CPR lowers survival by 7–10%. |
Quick Tip:
If an AED arrives, turn it on and follow the voice prompts, continue chest compressions until the device tells you to stop.
Key Reminder:
Hands-only CPR is simple but powerful. Acting fast, even imperfectly, is far better than waiting for help to arrive.
What Does AHA Hands-Only CPR Include?
The AHA offers several CPR training kits for schools, workplaces, and community groups. Most of these resources include manikins, instructional videos, and guides. Meanwhile, the key points associated with compressions-only CPR for AHA include:
| Key Point | Description |
| Public Awareness Campaigns | The AHA runs nationwide efforts encouraging everyday people to perform CPR immediately after cardiac arrest. It proves that quick action can double or triple survival rates. |
| Community & Workplace Training | Offers training kits with manikins, videos, and instructor guides for schools, offices, and community centers to teach CPR in under an hour. |
| Simple Two-Step Method | Focuses on just two steps: 1) Call 911, and 2) Push hard and fast in the center of the chest. Designed for untrained bystanders to use confidently. |
| Accessibility | The AHA’s CPR Anytime® kits and short 30-minute training modules make learning easy and self-paced. It helps families, students, and employees gain skills without formal classroom sessions. |
Hands-Only CPR for Kids
Hands-only CPR works best for teens and adults, but it can also be used for children in emergencies when you’re untrained or uncomfortable giving rescue breaths. For infants under 1 year, always use both compressions and rescue breaths, since their oxygen needs are higher.
| Category | Adults | Children |
| Recommended Use | Primary method for untrained rescuers. | Use if you’re untrained or unwilling to give breaths. If trained, include both compressions and rescue breaths (30:2 ratio). |
| Compression Depth | About 2 inches (5 cm). | About 2 inches (5 cm) for children; 1.5 inches (4 cm) for infants. |
| Compression Rate | 100–120 per minute. | 100–120 per minute. |
| Rescue Breaths | Not included in hands-only CPR. | Include if trained, 2 breaths after every 30 compressions. If untrained, continue compressions only until help arrives. |
Key Reminder:
If you’re not trained in CPR, it’s far better to give hands-only compressions than to do nothing. Push hard and fast in the center of the chest until emergency help takes over.
What is the Use of a Hands-Only CPR Video?
A hands-only CPR video is a valuable learning tool that can visually showcase the correct technique. All learners can easily remember key concepts associated with CPR tools and techniques through this resource.
The video also shows real-time pacing for chest compressions to help viewers grasp the recommended compressions per minute rhythm. They can also see proper hand placement, body posture, and compression depth, so that they do not hesitate to assist in a real emergency.
Who Should Perform Hands-Only CPR?
Anyone can perform compressions-only CPR. The best part is you don’t need to be a healthcare professional to help victims in emergencies. So, the ideal candidates include any untrained bystanders at the scene of a sudden collapse. They could be school staff and students, workplace employees, community volunteers, or even family members of people with heart conditions.
Even if you’re unsure about your technique, doing something is better than doing nothing. Effective bystander CPR can always increase survival rates. Be assured that you are also protected under the Good Samaritan law, which protects individuals who provide CPR to victims in good faith.
Get a Hands-Only CPR Certificate Now!
Hands-only CPR is a simple yet powerful tool that can save lives in sudden cardiac arrest situations. You can easily learn and practice this skill to equip yourself to take immediate, effective action when every second counts. Remember the two key steps associated with this unique CPR technique: Call 911 and push hard and fast in the center of the chest.
You can also watch a short video or download a PDF to gain more details about CPR tools and techniques. Don’t wait for an emergency. Get certified today in CPR/AED and be ready to save a life when it matters most.
