You may have seen CPR performed on television, but coming face-to-face with someone experiencing cardiac arrest throws you into the driver’s seat in a way that many people are unprepared for.

Now that the British Heart Foundation have updated their guidance on how to perform CPR, it’s important to familiarise ourselves with the updates so that we can give medical assistance as safely as possible.

Step 1: Shake and shout

If you come across someone who is unconscious, you can’t jump straight into action, though you might want to. You must first look around you for potential danger or risks to you before proceeding.

If you deem the surroundings to be safe, you can then check for a response. Someone experiencing cardiac arrest will be unconscious, but they will either be breathing irregularly or not breathing. Gently shake the person’s shoulder and ask loudly “are you alright?”.

Next, shout for help from someone nearby. If you are without company, shout loudly to attract attention but do not leave the person’s side.

Step 2: Call 999

If there is someone nearby and the unconscious person is breathing irregularly or not breathing:

• Ask someone to call 999 immediately and ask for an ambulance
• Ask someone for a public access defibrillator (PAD)

If there’s no one around, call 999 before starting chest compressions.

Step 3: Cover mouth and nose with cloth

This step is only performed if you’re sure the person is breathing normally. If you’re confident the person is breathing normally, put them in the recovery position. Instructions and diagrams on how to put someone in the recovery position can be found here.

If you think there’s a risk of Covid-19 infection or you belong to a vulnerable group, first lay a towel or piece of clothing over the mouth and nose before putting them in the recovery position. Do not put your face close to theirs.

Step 4: Give chest compressions (do not give rescue breaths)

This step is only performed if the person is not breathing or not breathing normally.

• Kneel down next to the person
• Place the heel of one hand in the centre of their chest. Place your other hand on top of the first. Interlock your fingers.
• With straight arms, use the heel of your hand to push the breastbone down firmly and smoothly so that the chest is pressed down between 5-6cm, and release
• This should be done at a rate of 100-120 chest compressions per minute. This is around 2 compressions per second.

Step 5: Keep going

Keep going until professional help arrives and takes over or the person starts to show signs of regaining consciousness, e.g. coughing, opening their eyes, speaking or breathing normally.

If you’re getting tired or achy and there’s someone nearby, ask them to take over. After the ambulance crew have taken over, wash your hands thoroughly with soap and water or use an alcohol-based hand gel.

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