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Each year, an estimated 436,000 Americans die from cardiac arrest when the heart abruptly stops beating, causing the person to collapse and stop breathing.

Immediately performing hands-on cardiopulmonary resuscitation (CPR) can more than double the victim's odds of survival. CPR does not restart the heart, but the chest compressions can keep blood flowing to the person's brain and other vital organs until they receive emergency medical care.

New research presented at the American Heart Association (AHA) Resuscitation Science Symposium in November 2024 found that beginning CPR on a person with cardiac arrest within two to 10 minutes improves their chances of survival with intact brain function.

"Without CPR, only 10% of out-of-hospital cardiac arrest victims survive, and every minute that goes by, chances of survival decrease by 10%," says Dr. Eric Goralnick, associate professor of emergency medicine at Harvard Medical School.

Helpful hands

Yet fewer than half of the people who have a cardiac arrest outside a hospital receive CPR from a bystander. The main reason is a lack of CPR training.

In fact, a recent scientific statement from the AHA found that although many people say they've received CPR training at some point in their lives, few are current on their training. "All adults should take an in-person CPR class at least once and have a refresher course every two to three years," says Dr. Goralnick. "You could save the life of a family member, friend, or stranger."

Currently, the best way to learn CPR is to take a course offered by local chapters of the American Red Cross or the AHA. Classes range from one hour for basic CPR to a full day that includes first aid training.

Upon completion, participants receive CPR certification. While in-person classes are ideal as they offer hands-on training and direct feedback, online classes also are available, as are blended classes.

CPR classes also include training with an automatic external defibrillator (AED). An AED is a lightweight, portable device that analyzes a person's heart rhythm. The AED has two sticky pads with sensors that are attached to the person's chest. The sensors send information about the heart's rhythm to a processor in the AED.

If an abnormal rhythm is detected, the AED can deliver an electric shock through the chest to the heart to restore the rhythm back to normal. "AEDs are found in many public places, so use them if they are available," says Dr. Goralnick.

ABCs of CPR

How can you recognize whether a person is suffering cardiac arrest? Look for two key features.

Nonresponsive. The person does not react if you loudly say "Are you okay?" and firmly shake their shoulders. If the person is unresponsive, call 911.

Not breathing normally. Check if their chest rises and falls or put your face close to their nose and mouth to listen for normal breathing sounds. Labored, irregular breaths that sound like snorting or gasping are signs that the brain is not receiving adequate oxygen. Tell the 911 operator if you can't detect normal breathing.

About half of 911 operators are trained to provide verbal cues for CPR. Put the phone on speaker so you can begin CPR and continue to receive instructions until emergency medical service (EMS) personnel arrive.

"Even if you know CPR, during a crisis, it can be hard to think straight, and you will benefit from expert guidance," says Dr. Goralnick. Here are the basics for how to do CPR.

• Place the person on their back on the floor and kneel beside them.
• Place the heel of one hand on the center of the person's chest.
• Place the heel of the other hand on top of the first hand and lace the fingers of your top hand through the fingers of the bottom hand.
• Position your body so your shoulders are directly over your hands.
• Keep your arms straight, push down with your arms and hands, using your body weight to compress the person's chest. Push hard enough to press the chest down at least two inches. Let the chest completely rise before pushing down again.
• Continue pressing the chest hard and fast at a speed of 100 to 120 compressions per minute.
• Continue hands-on CPR until you notice an obvious sign of life or EMS arrives. If possible, enlist another person to take over after a few minutes, as performing the compressions can be tiring.

If you're not sure if someone needs CPR, always err on the side of caution, recommends Dr. Goralnick. "It's better to do CPR on someone who doesn't need it rather than not do it on someone who does."

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