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  1. “C-A-B” (Chest compressions, Airway, Breathing) is the recommended sequence for a single rescuer. Provide chest compressions before giving rescue breaths. Limit chest compressions to < 10 seconds.

  2. Compression rate should be 100-120/minute.

  3. Compression depth should be 2-2.4 inches (5-6 cm).

  4. Do not lean hands on the chest between compressions, to allow complete recoil between compressions.

  5. Continue compression-only CPR until arrival of AED or rescuers with additional training.

  6. If trained in rescue breathing, add rescue breaths as 30 compressions:2 breaths until skilled help arrives.

  7. Naloxone may be given for suspected life-threatening opioid-associated emergencies.

  8. Assessment of breathing and pulse checks may be done first by BLS Healthcare providers, but must be done in < 10 seconds.


The purpose of CPR is to temporarily provide effective oxygenation of vital organs, especially the brain and heart, through artificial circulation of oxygenated blood until the restoration of normal cardiac and respiratory activity occurs. The intended effect is to stop the degenerative processes of ischemia and anoxia caused by inadequate circulation and inadequate oxygenation.3 The time sensitivity of CPR in sudden cardiac death is emphasized in the American Heart Association “Chain of Survival” (Table 22–1).

Table 22–1

American Heart Association Chain of Survival

This chapter reviews basic CPR for adults and children ≥8 years old, including the approach to an unresponsive patient; the physiology and mechanics of closed chest compression techniques; and basic airway opening procedures, including initial management of an obstructed airway. This chapter is specifically directed toward healthcare providers, although key updates for lay rescuers are noted, given the healthcare provider's role in layperson education.

Table 22–2 outlines the sequence of steps to be taken when someone is found unresponsive.

Table 22–2

Systematic Approach to CPR

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