CPR and choking response

01 — Hands-only CPR for adults

Call 911, then push hard and fast in the center of the chest

The AHA recommends hands-only CPR for bystanders responding to an adult who has suddenly collapsed and is not breathing normally. Immediate CPR can double or triple survival odds from cardiac arrest. The most common reason bystanders hesitate is uncertainty about whether they will do it correctly. The AHA's answer to that is that imperfect compressions are better than none, and that the two most important variables are rate and depth.

Hands-only CPR for adults: place the heel of one hand on the center of the chest, between the nipples. Place your other hand on top and lace the fingers together. Keep your arms straight and compress at least 2 inches deep, then allow the chest to fully recoil before the next compression. Full recoil allows the heart to refill between compressions. Rate is 100 to 120 compressions per minute — this is fast. The song "Stayin' Alive" by the Bee Gees has a tempo of approximately 100 beats per minute and is a commonly cited reference for maintaining rate.

Hands-only CPR is appropriate for adult bystanders responding to sudden cardiac arrest. For infants and children, the AHA recommends conventional CPR with rescue breaths if the rescuer is willing and able, because respiratory failure rather than cardiac arrest is the more common cause of emergency in children.

• Check the scene for safety and confirm the person is unresponsive. Shout for help. Call 911 or have someone else call while you start compressions.
• Place the person on their back on a firm surface.
• Place the heel of one hand on the center of the chest. Stack your other hand on top and interlace fingers.
• Keep arms straight. Compress at least 2 inches deep at a rate of 100 to 120 per minute. Let the chest fully recoil between each compression.
• Continue until EMS arrives, an AED becomes available, the person shows obvious signs of life, or you are physically unable to continue.

02 — Conventional CPR

30 compressions, then 2 rescue breaths. Repeat.

Conventional CPR, which alternates chest compressions with rescue breaths, remains the standard for trained rescuers and is recommended for children and infants. The AHA compression-to-breath ratio for a single rescuer treating an adult or child is 30 compressions followed by 2 rescue breaths. With two trained rescuers, the ratio for infants and children changes to 15 compressions to 2 breaths.

To give a rescue breath: tilt the head back gently to open the airway, lift the chin, pinch the nose closed, and give one breath over one second while watching for the chest to rise. If the chest does not rise, reposition the airway and try again before resuming compressions. Avoid over-inflating — a visible chest rise is the goal, not a large breath.

For infants, cover both the mouth and nose with your mouth to form a seal. Give smaller puffs of air, only enough to see the chest rise. Infant lungs are very small; excessive breath volume can cause injury.

03 — Infant choking

Back blows and chest thrusts only — never abdominal thrusts for an infant

The 2025 AHA Pediatric Basic Life Support Guidelines specifically updated infant choking technique to eliminate the use of abdominal thrusts and replace them with chest thrusts paired with back blows. This change applies to infants under 1 year old. Children over 1 year receive back blows followed by abdominal thrusts, the same basic pattern as adults.

If the infant becomes unresponsive during choking, lower them carefully to a firm surface and begin infant CPR. Before giving rescue breaths, look into the mouth and remove any visible object. Do not perform blind finger sweeps — only remove an object you can clearly see.