How to perform CPR

Let me begin by saying that you can’t learn how to perform CPR from a blog post.

Consider the CPR guidelines below to be a jumping-off point before you take more-formal training.

And yes, you and your older Scouts and Venturers need to get trained in CPR. It could be the most important training you ever take.

Training — both in-person and online — is available through the American Red Cross, Emergency Care & Safety Institute, American Heart Association or your local Scout council.

Online courses are OK, but in order to be certified, you’ll need a practical component — a skills check with a certified instructor. The BSA recommends but doesn’t require certification for the Webelos First Responder adventure, Boy Scout rank advancement or First Aid merit badge. But it does require certification for Wilderness First Aid training.

The BSA doesn’t certify CPR instructors itself or offer its own CPR training; instead, it has training agreements with the American Red Cross and the Emergency Care & Safety Institute to use their courses. The course should be from a nationally recognized provider — “you’d be surprised to find out how many people develop their own programs,” says Bev Singel, a registered nurse on the BSA’s health and safety team.

Constantly under review

First aid and CPR guidelines are always under review and are revised regularly. These updates happen so frequently that it’s difficult for the BSA to keep its First Aid merit badge pamphlet or Boy Scout Handbook updated.

The 2010 edition of the Boy Scout Handbook, for example, teaches the steps as A-B-C-D: Airway, Breathing, Circulation, Defibrillation.

That’s no longer the recommended order. Now, the recommended sequence for a single rescuer is to initiate chest compressions before giving rescue breaths (C-A-B rather than A-B-C) to reduce the delay before the first compression. A single rescuer should begin CPR with 30 chest compressions followed by 2 breaths.

Which method to use

Instructors should teach using the current protocol under which they’re certified.

People performing CPR should use the methods under which they got trained.

Wherever you obtain CPR training, Singel encourages you to select a course that is for laypeople and not those courses intended for health care providers.

Chest compressions are the emphasis now

Here’s the latest (2015) guidance from the American Heart Association:

Untrained lay rescuers should provide compression-only (Hands-Only) CPR, with or without dispatcher guidance, for adult victims of cardiac arrest. The rescuer should continue compression-only CPR until the arrival of an AED or rescuers with additional training. All lay rescuers should, at a minimum, provide chest compressions for victims of cardiac arrest. In addition, if the trained lay rescuer is able to perform rescue breaths, he or she should add rescue breaths in a ratio of 30 compressions to 2 breaths. The rescuer should continue CPR until an AED arrives and is ready for use, EMS providers take over care of the victim, or the victim starts to move.

Current CPR guidelines for adult victims

Note: For all unresponsive adults, it is implied that permission to give care is granted. But you should always identify yourself as someone that knows CPR and ask permission before touching a victim, even if you think they are unconscious. 

  1. Make sure the scene is safe
  2. Assess for breathing and “signs of life,” such as movement. Trained professionals check for a pulse, but lay responders aren’t taught to do so.
  3. If no signs of life, have someone call 911 immediately. If you’re alone, call 911 before proceeding.
  4. If an AED is immediately available, perform CPR as the pads are applied and until the AED is ready to analyze the rhythm. Then use the AED.
  5. If no AED is available or while it’s being prepared, begin CPR:
    1. Perform 30 compressions and then two breaths.
    2. The compressions should be continuous at a rate of 100 to 120 per minute.
    3. Compression depth should be at least two inches.
    4. Two hands should be placed on the lower half of the breastbone (sternum).
    5. Allow full recoil of chest after each compression; do not lean on the chest after each compression.
  6. Continue this 30 compressions, two breaths pattern until an AED is ready, professionals are on the scene, the scene becomes unsafe, you are too exhausted to continue, another rescuer takes over to perform CPR for you or signs of life return (movement or breathing).

Current CPR guidelines for children (age 1 to puberty)

Note: You need to ask permission to care for the victim if the parent or guardian are present — even if the child is unresponsive If the parent/guardian is not present, then follow the steps. 

  1. Make sure the scene is safe
  2. Assess for breathing and “signs of life,” such as movement.
  3. If no signs of life in a witnessed collapse, have someone call 911 immediately. If you’re alone and you come across an unresponsive child or infant, give two minutes of care and then call 911.
  4. If an AED is immediately available, perform CPR as the pads are applied and until the AED is ready to analyze the rhythm. Then use the AED.
  5. If no AED is available or while it’s being prepared, begin CPR:
    1. Perform 30 compressions and then two breaths.
    2. The compressions should be continuous at a rate of 100 to 120 per minute.
    3. Compression depth should be at least one third the diameter of chest, or about 2 inches.
    4. Two hands or one hand for a very small child should be placed on the lower half of the breastbone (sternum).
    5. Allow full recoil of chest after each compression; do not lean on the chest after each compression.
  6. Continue this 30 compressions, two breaths pattern until an AED is ready, professionals are on the scene, the scene becomes unsafe, you are too exhausted to continue, another rescuer takes over to perform CPR for you or signs of life return (movement or breathing).

Current CPR guidelines for infants (less than 1 year)

Note: You need to ask permission to care for the victim if the parent or guardian are present — even if the child is unresponsive If the parent/guardian is not present, then follow the steps. For all unresponsive adults, it is implied that permission to give care is granted. But you should always identify yourself as someone that knows CPR and ask permission before touching a victim, even if you think they are unconscious. 

  1. Make sure the scene is safe
  2. Assess for breathing and “signs of life,” such as movement.
  3. If no signs of life in a witnessed collapse, have someone call 911 immediately. If you’re alone and you come across an unresponsive child or infant, give two minutes of care and then call 911.
  4. If an AED is immediately available, perform CPR as the pads are applied and until the AED is ready to analyze the rhythm. Then use the AED
  5. If no AED is available or while it’s being prepared, begin CPR:
    1. Perform 30 compressions and then two breaths.
    2. The compressions should be continuous at a rate of 100 to 120 per minute.
    3. Compression depth should be at least one third the diameter of chest, or about 1.5 inches
    4. Two fingers in the center of the chest, just below the nipple line
    5. Allow full recoil of chest after each compression; do not lean on the chest after each compression.
  6. Continue this 30 compressions, two breaths pattern until an AED is ready, professionals are on the scene, the scene becomes unsafe, you are too exhausted to continue, another rescuer takes over to perform CPR for you or signs of life return (movement or breathing).