The document provides instructions for performing cardiopulmonary resuscitation (CPR). It describes the steps to take before performing CPR including checking breathing and calling for emergency services. It then details how to perform chest compressions and rescue breaths in a repeated cycle for adults and children/babies. It also provides guidance on placing a casualty in the recovery position and dealing with vomiting during resuscitation.

1. CPR - Cardiopulmonary Resuscitation

2. CPR - Cardiopulmonary Resuscitation
• Before commencing CPR, follow the DRABC steps of the emergency action plan.
• If the casualty is breathing normally, carry out a secondary survey and place them
in the recovery position.
• If the casualty is not breathing normally, ask someone to dial 999 for ambulance
and bring an AED if possible.
• If you are on your own, do this yourself; you may need to leave the casualty. Them
perform resuscitation.

3. CPR - Cardiopulmonary Resuscitation
Start with chest compressions:
• Place the heel of one hand in the centre of the casualty’s chest, then
place the heel of your other hand on top and interlock your fingers
• Position yourself above the casualty’s chest with your arms straight.
• Press down on the breastbone 5 to 6cm then release the pressure
without losing contact between your hands and chest.
• Ensure that pressure is not applied over the casualty’s ribs.
• Use your upper body weight, not just your hands to apply the
pressure.
• Don’t apply pressure over the upper abdomen or the bottom end of
the breastbone.
• Do 30 chest compressions at a rate of 100 – 120 per minute.
• The combine chest compression with rescue breaths.

4. CPR - Cardiopulmonary Resuscitation
Rescue Breaths:
• Open the airway again, using head tilt and chin lift.
• Nip the casualty’s nose closed. Allow the mouth to open, but keep the chin lifted.
• Take a normal breath and seal your lips around the casualty’s mouth.
• Blow steadily into the casualty’s mouth, watching for chest to rise. Take about one
second to make the chest rise.
• Keeping the airway open, remove your mouth. Take a breath of fresh air and
watch for the casualty’s chest to fall as the air comes out.
• Re-seal your mouth to the casualty’s and give another rescue breath.
• Return your hands without delay to the correct position on the breastbone and
give another 30 chest compressions.
• Then given 2 more rescue breaths. Deliver the 2 rescue breaths in 5 seconds.
• Continue repeating cycles of 30 compressions and 2 rescue breaths.
• Only stop to recheck the casualty if they start breathing normally. Otherwise don't
interrupt resuscitation.

5. CPR - Cardiopulmonary Resuscitation
Rescue Breaths:
• If your rescue breaths don’t make the chest rise effectively, give
another 30 chest compressions. Then, before your next attempt:
• Check the casualty’s mouth and remove any visible obstruction.
• Recheck that the head is tilted for enough back and the chin is lifted.
• Do not attempt more than two breaths each time, before returning to
chest compressions.
• Continue resuscitation until: medical help arrives, the casualty starts
breathing normally, you become exhausted

6. CPR - Cardiopulmonary Resuscitation
Chest compression only resuscitation
• If you are untrained or unwilling, perform chest compression only, this will
circulate any residual oxygen in the blood stream, it is better than no
resuscitation at all.
• If chest compressions only are given, these should be continuous at the rate of
100-120 per minute.
• Stop to check the casualty only if they show signs of regaining consciousness
and breathing normally.
• If there is more than one rescuer; change over every two minutes to prevent
fatigue. Ensure the minimum of delay as you change over.

7. CPR - Cardiopulmonary Resuscitation
Vomiting
• It is common for a casualty who has stopped breathing to vomit while they are
collapsed.
• If the casualty has vomited, turn them onto their side, tip the head back and allow the
vomit to run out.
• Clean the casualty’s face then continue resuscitation, using a protective face barrier if
possible.
Hygiene during resuscitation
• Wipe the lips clean.
• If possible, use a protective barrier such as a “resusci-aid”
• As a last resort, some plastic with a hole in it may help prevent direct contact.
• If you are still in doubt of performing rescue breaths, give “chest compression only”
resuscitation.
• Wear protective gloves if available and wash your hands afterwards.

8. Resuscitation for children and babies
Often Rescuers are reluctant to perform CPR on children or babies because they
are afraid they may harm them. It is important to understand that it is better to
perform adult style resuscitation on a child than to do nothing at all.
If the child is not breathing normally:
• Get someone to call for an ambulance and bring a defibrillator if available, if you are
alone and have to leave the child to make the call, carry out the resuscitation for
approx. 1 minute before leaving the child.
• Keep the airway open by tilting the head and lifting the chin
• Nip the nose and seal your mouth around the child’s mouth
• Give 5 initial rescue breaths

9. Resuscitation for children and babies
Combine rescue breaths with chest compressions:
• Use 1 or 2 hands as required and depress the chest at least a third of its depth
• For a baby use 2 fingers to depress the chest at least a third of its depth
• Give 30 chest compressions at a rate of 100 – 120 per minute
• Open the airway again by tilting the head and lifting the chin, give 2 more rescue breaths
• Continue repeating cycle of 30 compressions o 2 breaths
Only stop if the child regains consciousness and start breathing normally – otherwise continue until help arrives.

10. Resuscitation for children and babies
If your rescue breaths don’t make the chest rise effectively:
• Give another 30 chest compression, then before you start again:
• Check inside the mouth and remove any visible obstruction, do not reach into the back of the
throat unless object is visible.
• Recheck there is enough head tilt and chin tilt
• Do not attempt more than 2 breaths each time before returning to chest compressions.

11. Recovery Position
When an unconscious person is lying on their back, their airway may
be blocked:
• The tongue may be touching the back of the throat
• Vomit might block the airway
Placing the casualty in the recovery position ensures that the tongue
will not fall to the back of the throat, and any vomit will run out of the
mouth.

12. Recovery Position
• Straighten the casualty’s body
• Check from head to toe for any sharp objects
that they may roll onto: pens earrings, glass,
keys, watches
• Kneel next to the casualty
• Lift the arm nearest to you and put it out at a
right angle to their body, with the elbow bent
and the palm facing upwards.

13. Recovery Position
• Lean over the casualty, take hold of their
other hand and bring it up to their cheek and
then hold the back of their hand against their
cheek.
• Use your other hand to take their hand
against their cheek

14. Recovery Position
• Use your other hand to take their far leg,
just above the knee, and pull it up, keeping
their foot on the ground.
• Keeping their hands against their cheek,
pull the far leg towards you from the knee
and roll them towards you, onto their side
• Ensure that the upper leg is bent at right
angles at both the hip and the knee
• Tilt the head back to ensure that the
airway remains open.

15. Recovery Position
• If an ambulance has not already been called, call for it now
• Continue to check breathing regularly, If it stops, return the casualty to
their back and perform CPR