Hands-Only CPR FAQs

Hands-only CPRIf someone has suddenly collapsed, is not breathing normally and is unresponsive they are in cardiac arrest.

Calling 999 and pushing hard and fast in the centre of their chest to the beat of Stayin' Alive by the Bee Gees until an ambulance arrives could help save their life.

They're simple actions but you may still have some questions about Hands-only CPR.

Why are you advocating Hands-only CPR when you show how to give rescue breaths on Heartstart courses?

There are appalling survival rates from out-of-hospital cardiac arrests in the UK. Less than 10 per cent of casualties survive to leave hospital, and yet many cardiac arrests are witnessed by members of the public. We have to try and improve those survival rates while facing the reality that most people don’t know how to give cardiopulmonary resuscitation (CPR).

Research shows people are more likely to start CPR if they only have to carry out Hands-only CPR on a casualty. CPR with rescue breaths should remain the gold standard but if someone is untrained, or unsure about how to give rescue breaths and chest compressions, Hands-only CPR is still more likely to increase a casualty’s chance of survival.

So if you’ve been trained in CPR, including rescue breaths, and feel confident using your skills, you should still give chest compressions with rescue breaths.

What do you mean by ‘hard and fast’?

It’s been shown that chest compressions are often carried out at the wrong depth and speed so ‘hard and fast’ is a very simple message that lots of people will hopefully remember. ‘Hard’ means pushing on the chest to a depth of 5cm to 6cm, and ‘fast’ means 100-120 compressions a minute, roughly the same speed as Stayin’ Alive by the Bee Gees.

How does somebody know if they’re trained or untrained?

There are dozens of organisations all offering individuals the chance to learn the skills needed to save a life and some training doesn’t even take two hours to complete. If you’ve never had any training or refresher training in the last year you’ll probably be classed as untrained. If you’ve had training but still feel unable or unwilling to give rescue breaths, you should carry out Hands-only CPR.

When should I help?

If someone has collapsed, is not breathing normally and is not responsive to shaking and shouting then Hands-only CPR can increase their chances of survival prior to a defibrillator and professional help arriving.

In the first few minutes after cardiac arrest, the casualty may be barely breathing, or taking infrequent noisy gasps. This is called agonal breathing and must not be confused with normal breathing. If someone is unresponsive and their breathing is noisy, infrequent or doesn’t seem normal, start Hands-only CPR.

Is a cardiac arrest the same as a heart attack?

No. A cardiac arrest is totally different to a heart attack. A cardiac arrest is when your heart stops pumping blood around your body.  You are unresponsive and won’t be breathing normally. Immediate CPR and defibrillation is needed to have any chance of survival.

Most heart attacks are caused by coronary heart disease, which is when one or more coronary arteries narrow due to a gradual build-up of fatty material within their walls. If this material becomes unstable, a piece may break off and lead to a blood clot forming.  This clot can block a coronary artery, starving part of your heart of oxygen-carrying blood causing damage to your heart muscle - this is a heart attack.

Heart attacks cause the majority of cardiac arrests in the UK.

What are someone’s chances of surviving a cardiac arrest with or without bystander intervention?

At the moment, less than 10 per cent of the 30,000 people in the UK who have a cardiac arrest out of hospital each year survive long enough to leave hospital alive. If someone carries out early CPR, it may double a casualty’s chances of survival. Hands-only CPR should increase the number of bystander interventions and save lives.

Can you do Hands-only CPR on children or babies?

If you’ve not been taught how to give rescue breaths it’s far better to do Hands-only CPR on children than to do nothing. Children's ribs are flexible so you’re very unlikely to cause damage.

Use two fingers for an infant under a year and one or two hands for a child over a year to make sure you compress the chest by about one third of its depth.  If you’ve been taught how to give rescue breaths then these should be used to help children; give five rescue breaths before you start chest compressions, then give two rescue breaths after every 30 chest compressions.

How long should a rescuer do chest compressions for?

Rescuers should continue to deliver Hands-only CPR until professional help arrives and takes over, or they become exhausted. You can also stop chest compressions if the casualty shows signs of regaining consciousness, such as coughing, opening their eyes, speaking, moving purposefully, as well as breathing normally. Ideally, if there is more than one rescuer they should swap over every two minutes until a defibrillator arrives to prevent tiredness.

If a casualty has other injuries should a rescuer move them or turn them over to administer Hands-only CPR?

Cardiac arrest takes priority over anything else, so yes.  If you don’t give Hands Only CPR then you are reducing the chance of the casualty surviving.  It may seem a difficult decision but saving someone’s life takes priority over other injuries.

What if ambulance control tells me to do something more than Hands-only CPR when I call 999?

Rescuers should always listen to the ambulance operator as they will be best placed to tell you how to help properly. If you’re trained, the operator will probably talk you through CPR with rescue breaths but if not, they’ll probably guide you through Hands-only CPR.

Will a casualty come out of cardiac arrest if Hands-only CPR is performed correctly?

Chest compressions alone will only very rarely be able bring someone out of a cardiac arrest. Most of the time a defibrillator is needed to ‘shock’ the heart to allow a normal heart rhythm to return. Hands-only CPR will help keep some oxygenated blood going to the brain before a defibrillator arrives and is an important link in the chain of survival.

If a rescuer is risking their own health or safety, should they still carry out Hands-only CPR?

No. A bystander should never attempt any form of CPR if they are risking their own safety, whether they are trained or untrained. They should call 999 and then wait for help to arrive.

What is a defibrillator?

A defibrillator (sometimes also known as an Automated External Defibrillator or AED) is a life-saving machine that can give the heart a controlled electrical shock during a cardiac arrest. For every minute that passes without defibrillation chances of survival decrease by about 10 percent. Research shows that giving a controlled shock within five minutes of collapse provides the best possible chance of survival.

The BHF has placed more than 9,700 defibrillators in the community since it started donating them in 1996. At least 230 lives have been saved through the charity’s investment.

Can you do Hands-only CPR for more than five minutes?

Hands-only CPR works best when an ambulance arrives within a few minutes. But even when help takes longer to arrive, Hands-only CPR is better than no CPR, so carry on until an ambulance arrives.

If someone is untrained, can’t they damage a casualty’s ribs doing Hands-only CPR?

Chest compressions should be carried out hard and fast for maximum effectiveness. That occasionally means a bystander could injure the casualty during the rescue, by bruising them or damaging a rib. However, chest compressions of 100-120 times a minute at a depth of 5cm to 6cm could help save the life of a casualty – a broken rib or bruising is a small price to pay.

Can somebody get sued if they do Hands-only CPR or CPR with rescue breaths?

No-one has ever been successfully sued in the UK for carrying out CPR. Without bystanders intervening by calling 999 or carrying out CPR there is a very small chance of someone surviving a cardiac arrest, so any CPR is better than no CPR. By simplifying the CPR message to hands only we hope to see more successful resuscitation attempts by bystanders.

How old do you need to be administer Hands-only CPR?

As long as they can give hard and fast chest compressions, to a depth of around 5cm to 6cm, Hands-only CPR can be administered by anybody.

Does Hands-only CPR mean the rescuer has to remove any of the casualty’s clothing?

Removing someone’s clothing on the upper chest will help make Hands-only CPR even more effective so it’s preferable. But rescuers can still carry out chest compressions through thin clothing, like a woman’s blouse.