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Cardiopulmonary Resuscitation (CPR)

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)

  1. 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)

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

      • Start Cardiopulmonary Resuscitation (CPR) immediately when cardiac arrest is recognized.
      • Push hard and fast (100–120 compressions/min).
      • Minimize interruptions in chest compressions.
      • Use an Automated External Defibrillator (AED) as soon as it becomes available.
      • Treat reversible causes (Hs & Ts) during advanced life support.
      • Early CPR and early defibrillation are the strongest predictors of survival.