Cardiopulmonary resuscitation (CPR) is a procedure to restart a heart that has stopped beating — a condition known as cardiac arrest.
Cardiac arrest isn’t the same thing as a heart attack, however. During a heart attack, blood flow to the heart muscle has been blocked or significantly reduced. It’s typically the result of a blocked coronary artery brought on by cardiovascular disease. Cardiac arrest means that the heart’s electrical system has stopped sending signals for the heart to beat.
A heart attack can sometimes progress to cardiac arrest, making CPR a potentially lifesaving procedure.
Is this an emergency?
A heart attack should always be considered a medical emergency. The longer the heart muscle is deprived of sufficient blood flow, the more lasting damage is likely to occur.
With prompt medical attention, surviving a heart attack is often possible. However, CPR should not be administered if the person is conscious and the heart is still beating on its own.
If someone around you has lost consciousness and is in cardiac arrest, it’s essential to call emergency services immediately. The emergency dispatcher should walk you through the procedures to follow while paramedics head to your location.
If someone around you is showing signs of a heart attack, offer to call medical help. Stay with them until help arrives or their symptoms subside.
Performing CPR on a person whose heart attack has progressed to cardiac arrest should ideally be done by someone with training. However, if no one with formal CPR training is available, following these basic steps could make all the difference.
After calling emergency services (like 911) and making sure you and the person in crisis are safe (away from traffic or dangerous electrical wires, for example), place the person on their back on a flat, but firm surface.
- Place one hand on top of the other, with the heel of the bottom hand on the person’s sternum (breastbone).
- Place your body directly over your hands.
- Press down on the chest, about two inches.
- Press rapidly, about two times per second.
Repeat until paramedics arrive or someone brings an automated external defibrillator (AED) to the scene. An AED can deliver lifesaving shocks to a person in cardiac arrest, essentially “jump-starting” their heart.
CPR can be exhausting to perform, so it may be helpful to rotate with another person if paramedics do not arrive immediately.
How to use an automated external defibrillator (AED)
Many public places have AEDs available for use during an emergency, and they’re designed for anyone to be able to use.
- Turn on AED and follow voice prompts as instructed.
- Remove all clothing and jewelry on the chest.
- Make sure the chest is dry.
- Place first pad on the upper right side of the chest, just below the armpit.
- Place second pad on the upper left side.
- Make sure pads are plugged into the AED.
- Make sure no one is touching the person (say “clear!”).
- Let AED analyze the heart rhythm.
- When instructed, deliver the shock with the AED (usually by pressing a button).
If the AED does not advise giving a shock, begin CPR immediately.
CPR procedure for children and infants
Children and infants are unlikely to have attacks, however, there may be other reasons why CPR could be a lifesaving procedure for a young child in an emergency. The basics of CPR are similar, but accommodations should be made for the child’s small frame, according to the American Red Cross.
- CPR for a small child is done in the same way as it is for an adult, only one hand instead of two is used for the chest compressions.
- For an infant, place both thumbs side by side on the center of the baby’s chest. Wrap the other fingers around the back of the infant for support. Perform 30 fast compressions, always allowing the chest to return to its resting position.
If someone is having a heart attack but is alert with a steady heartbeat, CPR is not appropriate. In a case like this, you may do more harm to the heart than if you did nothing and waited for paramedics to arrive.
Also, if you have been performing CPR and the person shows signs of life, such as open eyes and regular breathing, stop CPR immediately. Allow the person to recover, but be prepared in case the individual’s heart stops beating again.
A 2020 analysis of 141 studies found that while the survival rate of people receiving CPR has increased in recent years, it is still well below 50 percent. For example, the analysis found that the average 1-year survival rate for people who underwent CPR was still only 13.3 percent from 2010 to 2019.
As long as a person having a heart attack is alert and breathing, there is no need for CPR. But if that individual’s heart stops beating, CPR could be a lifesaver. Just remember to call emergency services like 911 before taking any action and, if possible, check the area or have someone nearby try to locate an AED.
Be ready to turn over the care of a person in cardiac arrest to someone with CPR training or who has an AED. Local Red Cross chapters, hospitals, and other organizations often offer free or low-cost CPR and first aid classes. Consider taking one, especially if you care for or live with someone at high risk for heart attack or cardiac arrest.
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