Chest Compression – Technique, Steps and Guidelines
Chest compression is a life-saving emergency measure used during cardiac arrest. By rhythmically pressing on the chest, circulation is artificially maintained until professional help arrives.
Things worth knowing about "Chest Compression"
Chest compression is a life-saving emergency measure used during cardiac arrest. By rhythmically pressing on the chest, circulation is artificially maintained until professional help arrives.
What Is Chest Compression?
Chest compression – also referred to as cardiac compression or thoracic compression – is the core component of cardiopulmonary resuscitation (CPR). It is performed when the heart has stopped beating and the affected person is unconscious and not breathing normally. By applying firm, rhythmic pressure to the chest, blood is mechanically pumped through the body to supply vital organs – especially the brain and heart – with oxygen until emergency medical services arrive.
When Is Chest Compression Needed?
Chest compression is required whenever a person is in cardiac arrest. Key signs include:
- Unconsciousness (the person does not respond to voice or touch)
- Absence of normal breathing (no visible breathing movements or only gasping breaths)
- No detectable pulse
In these situations, every second counts. Starting chest compression immediately can significantly increase the chance of survival.
How to Perform Chest Compression
Preparation
Before beginning chest compression, call the emergency services immediately (e.g., 911 in the USA, 999 in the UK, 112 in Europe) or instruct a bystander to do so. Position the person on a firm, flat surface.
Technique
- Kneel beside the person at chest level.
- Place the heel of one hand on the center of the chest (lower half of the breastbone) and place the other hand on top, interlacing the fingers.
- With arms straight and using body weight, press the chest down at least 5–6 cm (2–2.4 inches).
- Maintain a compression rate of 100–120 compressions per minute.
- Allow the chest to fully recoil after each compression without lifting the hands away.
Combination with Rescue Breaths
If the rescuer is trained in mouth-to-mouth ventilation and willing to perform it, a ratio of 30 compressions to 2 rescue breaths is recommended. For untrained bystanders, hands-only CPR (continuous chest compressions without rescue breaths) is equally effective and is explicitly recommended by major resuscitation guidelines.
Use of an Automated External Defibrillator (AED)
As soon as an automated external defibrillator (AED) is available, it should be applied as quickly as possible. The AED provides clear voice instructions and, if necessary, delivers an electric shock to restore a normal heart rhythm. Chest compressions should be paused only briefly during the shock and resumed immediately afterward.
Prevalence and Importance
Cardiac arrest outside of a hospital is one of the leading causes of death in many countries. Research shows that bystander CPR can double or triple the chance of survival. Despite this, many witnesses of cardiac arrest do not intervene – often due to uncertainty or fear of making mistakes. Raising public awareness and CPR training are critical public health priorities.
Safety for Rescuers and Patients
Many people hesitate because they are afraid of breaking ribs or causing harm. While rib fractures can occur with proper technique, they are considered an acceptable risk compared to death from cardiac arrest. The guiding principle is: imperfect chest compressions are always better than no compressions at all. In most countries, Good Samaritan laws protect bystanders who act in good faith during an emergency from legal liability.
References
- European Resuscitation Council (ERC): Guidelines for Resuscitation 2021. Resuscitation, 161 (2021).
- American Heart Association (AHA): 2020 Guidelines for CPR and Emergency Cardiovascular Care. Circulation, 142(16 Suppl 2), 2020.
- World Health Organization (WHO): Basic Emergency Care – Approach to the Acutely Ill and Injured. WHO Press, Geneva, 2018.
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