Chest Compressions Only CPR

Chest compressions-only CPR, also known as hands-only CPR, is a lifesaving technique useful in emergencies involving adults who have suddenly collapsed. This form of cardiopulmonary resuscitation (CPR) emphasizes continuous, uninterrupted chest compressions without the incorporation of rescue breaths. It is recommended for use by bystanders who witness an adult experiencing a sudden cardiac arrest when a trained professional or conventional CPR is not immediately available.

The American Heart Association (AHA) endorses chest compressions-only CPR as an effective alternative for untrained rescuers or those hesitant to perform mouth-to-mouth resuscitation. The technique is relatively simple to perform and can be taught to the general public, thus expanding the potential for lifesaving interventions in critical moments.

The Rationale Behind Chest Compressions-Only CPR

Research has shown that during the first few minutes following a sudden cardiac arrest, the lungs and blood contain enough oxygen to sustain vital organs without the addition of rescue breaths. It is the circulation of this oxygenated blood that is most critical, and chest compressions serve to pump blood to the heart and brain.

Chest compressions-only CPR streamlines the resuscitation process, reducing hesitation from potential rescuers who may fear performing mouth-to-mouth incorrectly or who may be concerned about disease transmission. By maintaining blood flow within the body, chest compressions alone can significantly increase a victim's chance of survival until professional medical assistance arrives.

Technique and Implementation

When performing chest compressions-only CPR, the rescuer should place the heel of one hand over the center of the victim's chest, between the nipples. The other hand is then placed on top of the first, interlocking the fingers. With straight arms and shoulders directly above the hands, the rescuer uses their body weight to compress the chest at least two inches deep at a rate of 100 to 120 compressions per minute – akin to the beat of the song "Stayin' Alive" by the Bee Gees.

It is critical to minimize interruptions in chest compressions. Pauses can lead to a significant reduction in the survival rate, as blood flow to the brain and heart is decreased. Thus, the rescuer should continue compressions without stopping until emergency medical services (EMS) take over or an automated external defibrillator (AED) is ready to use. If the rescuer becomes fatigued, it is advisable to switch with another willing bystander without pausing the compressions.

Effectiveness and Survival Outcomes

Several studies have highlighted the effectiveness of chest compressions-only CPR in increasing survival rates. Notably, the simplicity of the technique has encouraged more bystanders to take action in emergencies. Survival rates from cardiac arrest can double or even triple when a bystander performs CPR promptly, with chest compressions-only CPR being a significant factor in this improvement.

Limitations and Considerations

While chest compressions-only CPR is an effective intervention for adults who have suffered a cardiac arrest, it is not universally applicable for all types of emergencies. For instance, children, infants, and victims of drowning, drug overdose, or collapse due to breathing problems may benefit more from traditional CPR, which includes rescue breaths. In such cases, the body's oxygen reserves are often depleted, and rescue breaths become necessary to introduce oxygen into the lungs and bloodstream.

Moreover, while hands-only CPR is a vital skill, it is not a substitute for comprehensive CPR training that includes rescue breaths and AED use. Comprehensive CPR training enables a rescuer to assess the situation and apply the most appropriate CPR technique.

Public Awareness and Education

The adoption of chest compressions-only CPR as a public health strategy has led to the development of awareness campaigns to educate the public on the importance of immediate action during a cardiac emergency. These campaigns often include instructions on performing chest compressions and guidance on recognizing the signs of a cardiac arrest, such as sudden collapse, unresponsiveness, and absence of normal breathing.


Chest compressions-only CPR represents a significant evolution in the approach to emergency cardiac care for non-medical bystanders. Its simplicity, coupled with its effectiveness, makes it a critical component in the chain of survival for victims of sudden cardiac arrest. By providing a straightforward and accessible option for immediate intervention, chest compressions-only CPR has the potential to save lives and improve outcomes for countless individuals each year. Regular training and refreshers for the general public on this technique can further enhance its life-saving potential, making it an essential skill for everyone to learn.