Cardiopulmonary Resuscitation (CPR)

First Aid

Overview

Adapted from St John’s Ambulance guidance and the Resuscitation Council UK 2025 Guidelines (published 27 October 2025)

Defibrillation: send someone for the nearest automated external defibrillator (AED) as soon as CPR has started — the 999 call handler can tell you where it is. Anyone can use an AED; no training is required. Switch it on and follow the spoken prompts. Do not delay or interrupt chest compressions to fetch one if you are on your own. For infants and children under about 25 kg (roughly under 8 years), use paediatric mode or paediatric pads if available; otherwise use the AED in standard adult mode

Unresponsive but breathing – Baby (under one year old)

Open the airway: place one hand on the forehead and tilt the head back, then place one fingertip of your other hand on the point of the baby’s chin and raise it

Check breathing i.e. chest movement, sounds of breathing and breaths on your cheek

Place them in the recovery position if breathing normally (cradle them in your arms, with their head tilted downwards)

Unresponsive but breathing – Child and adult

Open the airway: place one hand on the forehead and tilt the head back, then place one fingertip of your other hand on the point of the chin and lift it

Check breathing i.e. chest movement, sounds of breathing and breaths on your cheek

If they are breathing normally, put them into the recovery position from a lying down position (place their arm nearest you at a right angle to their body, with the palm facing upwards. Take their other arm and put it across their chest so the back of their hand is against their cheek nearest you, and hold it there. With your other hand, lift their far knee and pull it up until their foot is flat on the floor. Now roll onto their side, pulling on their bent knee. Check their airway is open by tilting their head back and their chin forward. If you think they could have a spinal injury, use the jaw thrust technique (place your hands on either side of their face and lift the jaw with your fingertips) instead of tilting their neck

Unresponsive and not breathing – Baby (under one year old)

Call 999 immediately, using the speaker function of your phone so you can start CPR while you talk. If someone is with you, get them to call. Only if you are alone and have no phone should you give one minute's worth of CPR before leaving the baby to go for help

Place the baby on their back on a firm surface at waist height in front of you, or on the floor. Give 5 rescue breaths before starting chest compressions (at a rate of 100 to 120 a minute) with rescue breaths. Those with paediatric first aid training should use a ratio of 15 compressions to 2 breaths; otherwise, the standard 30:2 ratio used for adults is acceptable. Carry on with this sequence for as long as you can, or until help arrives. If the baby starts breathing normally again, stop CPR and put them in the recovery position (outlined above)

Rescue breath: Ensure the airway is clear and open. Take a breath in and place your lips around the baby’s mouth and nose to form an airtight seal. Blow steadily into the mouth until the chest rises. Remove your mouth and allow the chest to fall

Chest compression: Use the two-thumb encircling technique: place both thumbs side by side on the lower half of the baby’s sternum, with your fingers encircling the baby’s chest and supporting the back. Press down with your thumbs, compressing the chest by at least one-third of its depth. Release the pressure fully between each compression. This technique has been shown to produce more effective compressions and less rescuer fatigue than the older two-fingertip method

Unresponsive and not breathing – Child

Kneel down beside the child on the floor. Give 5 initial rescue breaths before starting chest compressions (at a rate of 100 to 120 a minute) with rescue breaths. Those with paediatric first aid training should use a ratio of 15 compressions to 2 breaths; otherwise, the standard 30:2 ratio used for adults is acceptable. Call 999 immediately, using the speaker function of your phone; only if you are alone with no phone should you give one minute's worth of CPR before going for help. Carry on with this sequence for as long as you can, or until help arrives. However, if the child starts breathing normally again, stop CPR and put them in the recovery position (outlined above)

Rescue breath: Ensure the airway is open, pinch their nose closed, take a deep breath and seal your lips around their mouth. Blow steadily into the mouth until the chest rises

Chest compression: Place the heel of one hand on the lower half of their sternum, in the centre of their chest, making sure you keep the fingers off the ribs. Lean over and, with your arm straight, press down vertically on the sternum so that the chest goes down by at least one-third of its depth. Release the pressure without removing your hand from their chest and allow the chest to come back up fully

Unresponsive and not breathing – Adult

Call 999 for any unresponsive adult as soon as possible — make the call first, using the speaker function of your phone, and assess breathing while you wait for it to be answered (RCUK 2025: rescuers no longer need to confirm abnormal breathing before calling). Kneel down beside them on the floor. Place the heel of one hand on the lower half of the breastbone, in the centre of the chest, place your other hand on top and interlock your fingers. With straight arms and your shoulders directly above the chest, press down at least 5 cm but not more than 6 cm, allowing the chest to come back up fully between compressions. Give 30 chest compressions (at a rate of 100 to 120 a minute) followed by 2 rescue breaths. If you are not trained or not willing to give rescue breaths, give continuous chest compressions without stopping. Carry on with this sequence for as long as you can, or until help arrives. If the person starts breathing normally again, stop CPR and put them in the recovery position

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