CPR can help keep the brain and other vital organs alive during cardiac arrest by pushing oxygen-filled blood throughout the body. High-quality chest compressions are the most important part of CPR and have the biggest impact on survival of cardiac arrest.
So, it’s crucial that you practice proper hand placement when performing chest compressions.
CPR hand placement for adults
For adults, position your hands in the center of the chest between the nipples. Follow these chest compression steps to ensure you are positioned correctly:
Place the heel of one hand in the center of the chest on the breastbone.
Place the heel of the other hand directly on top of the first.
Lift or interlace your fingers.
Position your shoulders directly over your hands.
Keep your arms straight.
Push straight down (aim for a compression depth of at least 2 inches).
Allow the chest to fully rise between compressions. And avoid lifting your hands completely off the chest.
Push hard and fast until you see obvious signs of life or until EMS arrives and takes over.
CPR hand placement for children and infants
While the overall goal of compressions is the same, there are a few key differences to note when performing CPR on a child or infant.
For children age 1 year to puberty, continue to position your hands in the center of the chest between the nipples. Use 1 or 2 hands for compressions, depending on the size of the child. If you become fatigued during compressions, use both hands to ensure you continue to reach the desired depth (about 2 inches or 1/3 the depth of the child’s chest).
For children younger than 1 year, position 2 fingers in the center of the chest just below the nipple line. An infant’s body is much smaller, so you only need to use 2 fingers for compressions instead of your hands. Aim for a compression depth about 1.5 inches or 1/3 the depth of the child’s chest.
High-quality compressions save lives
Anyone can perform compression-only CPR, even without training. To recap:
Action | Adult | Child | Infant |
Compression Technique | 2 hands | 1 or 2 hands | 2 fingers |
Compression Location | Center of chest between nipples | Center of chest just below nipple line | |
Push Hard | At least 2 inches | About 2 inches | About 1.5 inches |
Push Fast |
Contact your local Training Center to practice your compression technique and get certified in CPR, AED and First Aid.
Cardiopulmonary resuscitation (car dee oh PULL mon air ee ree SUS I TA shun) is a combination of chest pumping (compressions) which moves blood from the heart to
the body, and mouth-to-mouth breathing which sends oxygen to the lungs.
How the Lungs and the Heart Work
The lungs’
purpose is to breathe in (inhale) air that is made of oxygen, which we need to
live. The heart pumps the blood to the lungs and to the body.
The right side of the heart receives blood from the body and pumps it to the lungs. While
in the lungs, the blood absorbs oxygen and then returns to the left side of the heart. The blood with the oxygen is then pumped throughout the body. Then, when the body takes
all the oxygen needed to live, the used blood returns to the lungs with
carbon dioxide, which is the air we breathe out (exhale).
If the baby stops breathing or the heart stops beating
If a baby stops breathing, he or she is not getting the oxygen needed to stay alive. If breathing stops, the heart will also soon stop.
YOU MUST ACT IMMEDIATELY BY:
- Pumping the child's heart with your hand (compressing).
- Breathing air into the child’s lungs (ventilating).
How to do Cardiopulmonary Resuscitation (CPR)
If you think the baby is not breathing:
- Check to see if the baby will respond to you. Tap the heel of the baby’s foot and call his or her name to see if he responds.
- If the baby does not respond, call out for someone to call 911 or use your cell phone to call 911 and put it on ‘Speakerphone’ while you start CPR.
- Turn the baby flat on his back on a hard surface.
- Look at baby’s face and chest to see if baby is breathing. Look for at least 5 seconds, but no more than 10 seconds (see chart on page 3, step 1).
- If baby is not breathing, remove clothes from his or her chest.
- Find the right position for chest compressions by drawing an imaginary line between the nipples to find the middle of the breastbone.
- Place 2 fingers just below that line on the breastbone and push down hard on the breastbone 1½ inches toward the backbone. Let the chest come back to its normal position after each compression. Compressions are done fast at a rate of 100 per minute.
- After you have compressed the chest 30 times, open the baby's airway for mouth-to-mouth breathing using the head lift-chin lift method (see chart on page 3, step 3). Tip the head back with one hand on the forehead. Use the tips of the fingers of your other hand to lift the chin upward. Be careful not to close the baby's mouth completely. Tilt the head just until the nose is aimed at the ceiling. Do not tilt the head too far back because this may close the baby's airway).
- Give 2 breaths (see chart on page 3, step 4). To do this, place your mouth over both the baby's mouth and nose to form an airtight seal. Breathe in only enough air to make the baby's chest rise. Since the baby's lungs are small, only small puffs of air are needed to fill them.
- Repeat 30 compressions and 2 breaths for a total of 5 times.
- If you still have not called 911 because you are alone and did not have a cell phone, call 911 after 5 sets of compressions and breaths. Then, resume CPR until help arrives. If help is already on the way and the child is not moving or breathing, continue CPR.
IMPORTANT: You must practice CPR on a mannequin (doll) with a nurse to be sure you are doing it correctly. This should be done before you leave the hospital.
NOTE: If you wish to become certified in CPR, contact the American Heart Association or the Red Cross in your community.
Resources: Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care 2010, American Heart Association
Quick Reference for CPR
(Tape to a wall in a suitable place.)
(Breaths per minute_________________ Compressions per minute__________________)
Emergency Phone Numbers
Fill in the phone numbers, copy them, and tape them by your telephone:
Emergency Squad:_____________________________ | Doctor:______________________________ |
Other:_____________________________ | Other:_____________________________ |
Cardiopulmonary Resuscitation (CPR) for Infants (PDF)
HH-II-59 8/81, Revised 12/17, Copyright 1981, Nationwide Children's Hospital