CPR 101: Everything You Need to Know to Help in an Emergency

Much like earthquake or wildfire prep, CPR is one of those skills that is good to have in your back pocket in case of emergency, but you hope you never have to use.  

Cardiopulmonary resuscitation, more commonly known as CPR, is a lifesaving maneuver used in emergencies when someone’s heart stops beating (like during cardiac arrest) or when someone stops breathing (like after drowning).

If you’ve ever witnessed a medical event like this, you know how scary it can be — that’s why it’s so important to know how to perform CPR. Thankfully, whether you’re CPR-certified or not, you can still potentially save a life if you know the basics.

How does CPR save lives?

When someone’s heart stops beating, or they’ve stopped breathing, CPR works by pumping blood from the chest and heart throughout the body.

“Your hands, in effect, become a substitute for the heart, maintaining blood flow to the brain and other organs until the heart’s pumping itself can be restored,” says Peter Kudenchuk, MD, a cardiologist at the Heart Institute at UW Medical Center – Montlake.

If someone is experiencing a medical emergency where CPR is needed, every second counts. Each moment without blood flow to the brain and other organs can risk permanent damage to the brain and body, or even death.  

The first few minutes are especially critical: If you start CPR within the first minute after a medical emergency, it gives the person the best chance of survival with minimal or no brain damage.  

If CPR or another intervention doesn’t occur within four minutes of the medical event, the risk of brain injury is significant, as many brain cells will have become severely damaged. After 10 minutes, the chance of survival is extremely low.

How to perform CPR if you’ve never done it before

The first step is to call 911. In Seattle and King County, every 911 caller will receive real-time instructions on bystander chest-compression-only CPR from the dispatcher if CPR is determined to be needed. 

The dispatcher will then give you the following instructions:

• Get the person on the ground and on their back.
• Put one hand in the middle of their chest, palm down, right on the breastbone between their nipples. You don’t have to remove their clothes unless they’re wearing a thick coat.
• Place your second hand on top of the first, locking your fingers.
• Start compressions: Focusing on the heel of your palm, press down as hard as you can on their chest, then release (allowing the chest to snap back to its original position).  
• Repeat the compression sequence repeatedly, back-to-back, without pausing.  
• Don’t stop until help arrives.

“The goal is to perform as close to 100 compressions per minute as possible in this manner until emergency medical services arrive,” says Kudenchuk. “Achieving the right rate of chest compressions can be accomplished by counting aloud as fast as you can — while pressing as hard as you can — then releasing quickly in cadence with your fast counting.”

Sometimes it’s helpful to time your compressions to the cadence of a song you know. You’ll want to use a tune with a tempo of 100 to 120 beats per minute — the most popular example is “Stayin’ Alive” by the Bee Gees.

And in case you’re wondering, it’s no longer recommended for untrained bystanders to use mouth-to-mouth, so you can just focus on the chest compressions.  

5 myths about CPR

Don’t let what pop culture and poorly intentioned internet forums have said about CPR get into your head. Kudenchuk says there are five myths to dispel about using CPR on someone:

Myth #1: CPR will hurt the patient

Truth: The person performing CPR is bringing life back to the patient.

“There is a small risk of fracturing ribs resulting from pumping the chest with CPR,” says Kudenchuk. “But it’s also important to remember that ribs heal, but death doesn’t. It’s far better to start CPR even if you’re unsure if it’s needed, since the consequence for the latter is certain death.”

Myth #2: If you’re untrained or forgot, you’ll do CPR wrong

Truth: If you’re calling 911, you’ll get on-the-spot help. But if not, remember, even imperfect CPR is better than no CPR at all.

Not sure whether someone needs CPR? That’s OK too — Kudenchuk says that if someone isn’t in true cardiac arrest, they will likely come to and push you off.  

Myth #3: You’re going to panic if you need to do CPR

Yes, it can sound difficult to stay calm when you’re doing something with an outcome that is, quite literally, a matter of life or death. But you might be surprised by how you react in the moment.

“In reviewing dispatcher-assisted CPR situations, I’ve been impressed how giving the caller something to do — the CPR instructions — while help is en route can have a calming effect,” says Kudenchuk. “It seems like CPR becomes not only lifesaving, but a distraction from what would otherwise result in the bystander doing nothing and panicking.”

After using CPR on someone, Kudenchuk says there are also therapy services available for both the person who performed the CPR maneuvers and the recipient.  

Myth #4: You can get hurt from CPR or catch a disease

Truth: With hands-only (compression-only) CPR, there is no risk of contracting a disease from someone.

Again, mouth-to-mouth CPR is no longer recommended for bystanders to perform — you can leave that to the trained healthcare professionals.  

Myth #5: Someone will sue you if the patient dies or is somehow harmed

Truth: There are good Samaritan laws in place that protect you when efforts to save someone’s life are made in good faith.  

Using automated external defibrillators  

If someone goes into cardiac arrest in a public building space — like an airport, school, grocery store or your office or apartment complex — it’s possible that automated external defibrillators, or AEDs, will be mounted on the wall. An AED can help restart a normal heartbeat when cardiac arrest causes a dangerously irregular heart rhythm.  

It should be used in addition to CPR, not as a replacement. If you are performing CPR, have someone else retrieve it, if possible, while you continue chest compressions. If you’ve never used an AED before, the instructions provided with the device are clear and easy to understand, and a shock won’t be delivered to the person experiencing cardiac arrest unless the AED senses that one is needed.

“If a 911 dispatcher is on the line, they can also assist in providing instructions for using the AED,” says Kudenchuk. “And like CPR, the sooner an AED is applied and can deliver a shock, the better.”

Getting CPR certified

While you can absolutely perform CPR on someone even if you’ve never taken an official class, you’ll feel much more confident in the moment if you’re CPR certified.  

“It never hurts to have some practice for a lifesaving skill,” says Kudenchuk

There are plenty of classes you can take to get your certification, whether through your city or county, or your employer might offer CPR training classes, too. A good place to start searching for a class near you is the American Heart Association or the Red Cross.

One last thing to keep in mind when doing CPR

Kudenchuk says the most important thing to remember is that you’re not alone.

“If you call 911, a dispatcher will instruct you and stay on the phone until emergency medical services arrive on the scene,” says Kudenchuk.  

Performing CPR may be scary, especially if you’ve never done it before, but remember: Every second counts.

“You’re giving the patient the best chance they will have for life in those minutes before additional help arrives,” says Kudenchuk. “During that time, you can do no harm — only good.”