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Dr. Pradeep Rajanna

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Emergency Specialist Doctor in Mysore
Reviewed by

Dr. Pradeep Rajanna

Consultant - Emergency Medicine

Manipal Hospitals, Mysuru

Know About CPR: A Step-by-step Guide

Posted On: Feb 09, 2024

blogs read 3 Min Read

How to do CPR Step by Step - Guidelines, Procedure, and Ratio

CPR, or cardiopulmonary resuscitation, is an important skill that everyone should learn. It involves a series of steps that can save a life when performed correctly. In this blog post, we will provide you with a step-by-step guide on how to do CPR, including information on the CPR procedure, CPR steps, CPR ratio, and CPR guidelines.


CPR Procedure

Before embarking on the intricate process of performing cardiopulmonary resuscitation (CPR), it is imperative to grasp the significance of evaluating the victim's condition. If you happen upon an individual who has collapsed and is unresponsive, the initial step is to ascertain whether they are breathing. Position your auricle adjacent to your orifice and nostril and listen for any indications of respiratory activity whilst observing the rise and fall of your thorax. Should there be no breathing evidence, do not hesitate to request emergency medical assistance urgently.

Once you have confirmed that the person is not breathing, you must create an open airway to deliver rescue breaths. Gently tilt their head back with one hand, whilst simultaneously elevating their chin forward with the other. This manoeuvre serves to extricate the tongue from the posterior of the pharynx and generate a clear passage for airflow. Proceed to grip their nares with your thumb and forefinger, inhale a deep breath, and establish a secure seal with your oral cavity around theirs, exhaling air into their lungs. Monitor their chest to ensure that it elevates with each breath.

After administering rescue breaths, the time has arrived to commence with chest compressions. Place the heel of your hand directly over the midpoint of the victim's chest and position your other hand atop. Intertwine your digits, and apply firm and swift pressure, aiming for an approximate depth of two inches. Permit the chest to recoil before commencing the subsequent compression. Iterate this process at a rate of 100 to 120 compressions per minute and ensure that the length of each compression is unique to maximise burstiness.

CPR Steps

Let's dive deeper into the CPR steps involved in performing CPR. To prevent heart attack, timing and speed are critical in performing CPR, so it's essential to follow each step as quickly and efficiently as possible.

Step 1: Assess the Victim's condition

The first step in performing CPR is to assess the victim's condition. Check for responsiveness and breathing.

Step 2: Call for Help

If the victim is not responsive or not breathing, call for help immediately.

Step 3: Open the Airway and Check for Breathing

Tilt the victim's head back and lift their chin to open their airway. Look, listen, and feel for signs of breathing.

Step 4: Perform Chest Compressions

Place the heel of your hand on the centre of the victim's chest and interlock your fingers. Press down two inches at a rate of 100 to 120 compressions per minute.

Step 5: Give Rescue Breaths

After 30 compressions, give two rescue breaths. Tilt the victim's head back and lift their chin, pinch their nose shut, and blow into their mouth.

Step 6: Repeat

Continue performing chest compressions and rescue breaths in a cycle until help arrives or the victim begins breathing on their own.

\When performing CPR, timing and speed are crucial. Chest compressions should be performed quickly and steadily, without interruption, to maintain circulation. Similarly, rescue breaths should be administered efficiently, without taking too much time, so as not to interrupt chest compressions. This timing is particularly important for infants, whose chests are smaller, and require faster compressions. 

CPR Ratio

The ideal CPR ratio for chest compressions to rescue breaths is 30:2. You should perform 30 compressions followed by two rescue breaths. Maintaining a steady rhythm is important to keep the victim's blood circulating.

The ratio may vary for infants, children, and adults. For infants, use two fingers to perform chest compressions and give rescue breaths using the "mouth to mouth and nose" method. For children, use one or two hands depending on their size and give rescue breaths using the "mouth to mouth" method.

It's important to monitor the victim's response while performing CPR. Look for signs of breathing or movement and listen for any sounds indicating that they are regaining consciousness.

CPR Guidelines

  • For adults, a prerequisite for effective CPR is the correct hand placement and pressure for chest compressions. In this regard, the AHA advises that the heel of one hand be used while administering chest compressions and the hand pressed down to a depth of no less than two inches. Two rescue breaths should be administered by tilting the head back and lifting the chin.

  • Regarding children, the technique is comparable to that used on adults. However, the pressure applied for chest compressions should be modified in line with the child's size. Specifically, the AHA prescribes those one or two hands be employed, contingent on the child's size, while the compressions should be delivered to a depth of about two inches. For rescue breaths, the tried and true "mouth-to-mouth" method should be used.

  • For infants, the modus operandi is slightly different. Specifically, two fingers ought to be used to administer chest compressions, while the rescue breaths are to be administered using the "mouth to mouth and nose" method. The prescribed depth for infant chest compressions is about one and a half inches.

  • It's important to remain informed on the latest CPR guidelines and best practices. The AHA updates these guidelines regularly, so staying current and taking refresher courses is crucial.

  • Knowing how to perform CPR can save a life. By following the proper procedure and ratio, you can help to circulate blood and oxygen to the vital organs, keeping the victim alive until help arrives. It's important to stay up to date on the latest CPR guidelines and techniques to ensure that you are prepared to act in an emergency.

  • If you haven't already, consider taking a CPR course and getting certified. You never know when you might need to use this life-saving skill. With the right knowledge and training, you can be prepared to act quickly and potentially save a life. For detailed information, call the help desk of Manipal Hospitals Mysore.


You will know if the chest lifts with ventilation. Determining if a pulse is produced by chest compression is difficult. Give it your all, and don't give up. Giving CPR incorrectly is better than not doing anything. 

No. Keep in mind that the victim of cardiac arrest is already dead. CPR is only beneficial. It is likely to help the sufferer in some way, even if it is not done perfectly. To do it more efficiently, learn how to perform CPR step by step 

The pressure that CPR applies to the sternum can break ribs. Research highlights that CPR results in broken ribs in up to 30% of cardiac arrest sufferers. Because the bones are more prone to cracking and the cartilage is less pliable as people age, there is a high risk of breaking the ribs after a CPR in the elderly and those with relevant medical concerns.

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