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Clinical Subject Page

Cardiopulmonary Resuscitation (CPR)

ICD-10

Does Not Apply

Specialty

Cardiology

Onset

For Life Threatening Conditions

Reviewed

July 2026
On This Page

Overview

Cardiopulmonary resuscitation (CPR) is an emergency life-saving procedure that combines high-quality chest compressions with ventilation to maintain blood circulation and oxygen delivery to vital organs during cardiac arrest until return of spontaneous circulation (ROSC) or advanced care is available.

Indications For Cardiopulmonary Resuscitation (CPR)

    • Unresponsive patient
    • No normal breathing (or only gasping)
    • No definite pulse within 10 seconds
    • Witnessed or suspected cardiac arrest

    Common Causes of Cardiac Arrest

    • Ventricular fibrillation (VF)
    • Pulseless ventricular tachycardia (pVT)
    • Pulseless electrical activity (PEA)
    • Asystole
    • Acute myocardial infarction
    • Severe hypoxia
    • Massive pulmonary embolism

Initial Assessment

    • Step 1: Ensure Scene Safety

      Ensure the environment is safe before approaching the patient.

      Step 2: Check Responsiveness

      Tap the patient’s shoulders and shout loudly:

      “Are you okay?”

      Step 3: Call for Help

      • Activate the Emergency Medical Services (EMS) by calling your local emergency number (e.g., 911, 999, 112).

      • Ask someone to bring an Automated External Defibrillator (AED) if one is available.

      Step 4: Check Breathing & Pulse

      Assess breathing and check for a pulse simultaneously for no more than 10 seconds.

      If the patient has no pulse and is not breathing normally (or is only gasping), begin CPR immediately.

      Step 5: Begin CPR

      Start high-quality chest compressions immediately while waiting for the Emergency Medical Services (EMS) and the Automated External Defibrillator (AED) to arrive.

Cardiopulmonary Resuscitation (CPR) Algorithm (Step-by-Step)

Adult Cardiopulmonary Resuscitation (CPR)

  1. Ensure scene safety.
  2. Check responsiveness.
  3. Activate EMS & obtain AED.
  4. Check breathing and pulse (≤10 sec).
  5. Start chest compressions.
  6. Open the airway.
  7. Give rescue breaths.
  8. Attach AED/defibrillator.
  9. Analyze rhythm.
  10. Deliver shock if indicated.
  11. Resume CPR immediately for 2 minutes.
  12. Repeat rhythm checks until ROSC or resuscitation is terminated.

Compression : Ventilation Ratio

    • 30 : 2 → One rescuer (adult)
    • 30 : 2 → Two rescuers (adult)
    • 15 : 2 → Two rescuers (infants & children)
Cardiopulmonary Resuscitation (CPR) Overview
Cardiopulmonary Resuscitation (CPR) Overview

High-Quality CPR Principles

Chest Compressions

  • Rate: 100–120/min

  • Depth: 5–6 cm (2–2.4 inches)

  • Allow complete chest recoil

  • Minimize interruptions (<10 sec)

  • Change compressor every 2 minutes

Ventilation

    • 2 breaths after every 30 compressions

    • Each breath over 1 second

    • Visible chest rise

    • Avoid excessive ventilation

Defibrillation & Cardiac Rhythms

Stents

  • Drug-eluting stent (DES) (preferred)

  • Bare-metal stent (BMS) (rarely used)

Other Devices

    • Balloon catheter

    • Guidewire

    • Guiding catheter

    • Intravascular ultrasound (IVUS)

    • Optical coherence tomography (OCT)

    • Rotational atherectomy

    • Intravascular lithotripsy (selected calcified lesions)

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Related Topics

Complications

    • Rib fractures
    • Sternal fracture
    • Pneumothorax
    • Internal organ injury (rare)
    • Gastric inflation and aspiration
    • Hypoxic brain injury
    • Death if ROSC is not achieved

Prognosis

  • Best when Cardiopulmonary Resuscitation (CPR) is started immediately.
  • Early defibrillation greatly improves survival.
  • Prognosis depends on the cause of cardiac arrest and time to ROSC.
  • Delayed CPR is associated with poor neurological outcomes and increased mortality.

Key Points / Clinical Pearls

  • CPR = Cardiopulmonary Resuscitation, used when a person is unresponsive and not breathing normally.
  • Ensure scene safety before approaching.
  • Check responsiveness and shout for help.
  • Activate the emergency response system and get an AED/defibrillator immediately.
  • Check for normal breathing and a pulse simultaneously in a healthcare setting; pulse assessment should take no more than 10 seconds.
  • If there is no normal breathing/no pulse → start CPR immediately.
  • Adult CPR: 30 chest compressions : 2 breaths.
  • Compression rate: 100–120/minute.
  • Compression depth: 5–6 cm (2–2.4 inches) in adults; avoid excessive depth >6 cm.
  • Allow full chest recoil after every compression and minimize interruptions.
  • Place hands in the center of the chest, on the lower half of the sternum.
  • Use the AED as soon as it arrives and follow its prompts.
  • If the AED advises a shock: deliver 1 shock → immediately resume CPR for 2 minutes until the AED prompts another rhythm check.
  • If the rhythm is non-shockable: immediately resume CPR for 2 minutes and continue reassessment.