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Hands-only CPR, in sixty seconds
Centre of the chest, 100 to 120 pushes a minute, 5 to 6 cm deep, let the chest come all the way back up, and do not stop. The rate, the depth, the fatigue problem, and a pacer that keeps you on the beat.
CPR in sixty seconds
- Unresponsive and not breathing normally? Gasping is not breathing. Treat it as a cardiac arrest.
- Call 112 (113 in Norway). Speaker on, phone on the floor. Stay on the line — the dispatcher will coach you.
- Push hard and fast in the centre of the chest: 5–6 cm in an adult, 100–120 per minute, letting the chest come all the way back up.
- Send somebody else for a defibrillator. Do not go yourself unless it is seconds away. Keep compressing.
- Turn the device on and do what it says. It decides whether to shock. After a shock, go straight back to compressions.
This is a reference written for bystanders, not a diagnosis, a training course or medical advice. It cannot tell you what is wrong with a particular person, and it does not replace the dispatcher on the other end of an emergency call — they can see what is near you and they will talk you through it. If you are worried about your own heart, or about a symptom, that is a conversation with a clinician rather than a page on a website.
The four numbers
Kneel beside the chest. Heel of one hand on the centre of the breastbone, the other hand on top, fingers interlocked, arms straight, shoulders directly above your hands so the push comes from your body weight and not your elbows. Press 5 to 6 centimetres deep at 100 to 120 compressions a minute, and let the chest recoil completely between pushes without taking your hands off it. Keep going without pauses. Those four numbers — position, depth, rate, recoil — are the whole technique, and they have been unchanged across the last three editions of the European guidelines.
Recoil is the half everybody forgets
Compression pushes blood out of the heart; release lets it fill again. A rescuer who leans on the chest between pushes — very common once tiredness sets in — gets the first half of the pump and not the second, and the blood flow collapses even though the compressions look energetic. Come all the way up, every time, without lifting your hands off the skin. If you can, watch the chest rather than your hands: it should visibly return to its resting shape between every compression.
Too slow is the usual error, too fast is real too
Untrained rescuers left to their own rhythm typically drift below 100 a minute, and each drop costs circulation. Above about 120 the chest no longer has time to refill and the extra speed buys nothing. The classic fix is to push to the beat of a familiar song at roughly 110 beats a minute, or to use the pacer on this page. Counting out loud in blocks of ten also keeps you honest and, unexpectedly, keeps the people around you calmer.
You will get tired faster than you think
Good compressions are hard physical work and quality measurably degrades after about two minutes, long before the rescuer feels finished. If anyone else is there, swap at every two-minute mark and make the changeover in under five seconds — call the swap in advance, kneel on the opposite side ready to go, and hand over at the top of a compression. If you are alone, do not stop; a tired rescuer at 80 per cent is worth far more than a rested one who paused.
Ribs, vomit and the things that make people stop
Cracking cartilage under your hands is common in older patients and is not a reason to stop or to push more gently — a healed rib is a survivable injury and an untreated arrest is not. If the person vomits, turn the head to the side, sweep out what you can in a couple of seconds and carry on. Do not stop to check for a pulse, do not stop when the ambulance is audible, and do not stop when a defibrillator arrives — keep compressing while somebody else opens it and sticks the pads on.
| What | Target | The usual mistake |
|---|---|---|
| Hand position | Centre of the chest, lower half of the breastbone | Too high, over the collarbones |
| Depth | 5–6 cm (about one third of chest depth) | Too shallow, from bent arms |
| Rate | 100–120 per minute | Drifting to 70–90 without a beat |
| Recoil | Chest fully back up between pushes | Leaning on the chest when tired |
| Interruptions | Under 5 seconds, and as few as possible | Stopping to re-check breathing |
| Rescuer change | Every 2 minutes if help is present | One person carrying on to exhaustion |
A pacer, and your coordinates
Two things a phone can genuinely do at the scene. The first paces your compressions at 110 a minute — the middle of the recommended band — and counts the two-minute marks at which a second rescuer should take over. The second reads your position out of the browser so you can say it aloud to the dispatcher, which is the fastest way to fix the hardest question in a rural emergency. Neither replaces the call.
Compression pacer
Pacer stopped
Target 100–120 per minute · 5–6 cm in an adult · swap rescuer every 2 minutes.
Read your position to the dispatcher
Say the street address if you have one. If you are on a trail, a lake, a forest road or a large site, decimal latitude and longitude are what the dispatcher wants — read the whole number including the decimals, slowly.
Sources: European Resuscitation Council Guidelines · International Liaison Committee on Resuscitation (ILCOR) · Käypä hoito national guideline: Elvytys · checked 2026-09-08
Frequently asked questions
How hard is 5 centimetres?
Harder than almost anyone expects — about a third of the depth of an adult chest, using your body weight through straight arms rather than arm strength. Rescuers consistently compress too shallowly rather than too deeply.
Do I have to give rescue breaths?
For an adult who collapses suddenly in front of you, compression-only CPR is the recommended approach for an untrained or unwilling rescuer and works well for the first minutes. Breaths matter more for children and for drowning.
What if I break a rib?
Keep going. Rib and cartilage fractures happen in a meaningful share of resuscitations, especially in older people, and they heal. Stopping compressions does not.
What to do, right now
Is this a cardiac arrest?
Two checks decide it: not responding, and not breathing normally. The noisy gasping that fools nearly everyone, why a brief seizure at the start is a cardiac sign, and why a heart attack is a different emergency.
The emergency call, and the address problem
What the dispatcher asks, why the phone goes on speaker on the floor, how dispatcher-guided CPR works, and the single hardest question in a rural arrest: where exactly are you?
Using a defibrillator, step by step
Open it, turn it on, bare the chest, follow the voice. What the machine decides for you, what it will never do, and the one instruction people get wrong — go straight back to compressions after the shock.
Where the pads go, and what gets in the way
Right collarbone and left ribs, or front and back. Chest hair, sweat, snow, a medicine patch, a pacemaker lump, an underwired bra, a tattoo: which of these actually matter and what to do about each.
"No shock advised" does not mean stop
The most misread sentence in public-access defibrillation. What the machine has actually detected, why roughly two thirds of arrests are not shockable, and why the pads stay on and the compressions continue.
Everything on this subject
Before the emergency, there is a long quiet stretch
Blood pressure, resting heart rate, movement and sleep are the part of this you can act on for years beforehand. TempoLife keeps them in one place, free to start.