Cardiopulmonary Resuscitation, or CPR, is an emergency procedure performed when a person’s heart stops beating. This sudden cessation of heart function, known as cardiac arrest, requires immediate intervention to circulate oxygenated blood to the brain and other organs until professional help arrives. To ensure a rescuer acts quickly and systematically in a high-stress situation, a foundational framework known as the “Three C’s” guides the initial response. This simple protocol outlines the preparatory steps necessary before the physical act of resuscitation begins.
The First C: Check
The initial step in an emergency is to systematically assess the surroundings to ensure safety before approaching the person in distress. This process, known as scene safety, involves looking for hazards such as active traffic, downed power lines, or unstable structures that could put the rescuer at risk. A rescuer cannot provide effective help if they also become a victim of the same danger.
Once the scene is deemed safe, the focus shifts to the person to check for responsiveness and breathing. The rescuer should tap the person firmly on the shoulder and shout loudly, “Are you okay?” If there is no response to verbal or physical stimuli, the person is considered unresponsive, indicating an immediate medical emergency.
Simultaneously, the rescuer must quickly look for signs of normal breathing. This check must not take more than 10 seconds, observing the chest and abdomen for rise and fall. Abnormal breathing, such as gasping or agonal breaths, should be treated the same as no breathing at all, signaling the need for immediate action.
The Second C: Call
If the person is unresponsive and not breathing normally, the next immediate step is to activate the Emergency Medical Services (EMS) system. This involves calling the local emergency number, such as 911 in the United States, to dispatch professional help. Getting the call made quickly is important, as the brain begins to suffer irreversible damage within minutes of blood flow stopping.
When speaking with the dispatcher, the rescuer must provide clear and concise information, including the exact location of the emergency and the nature of the person’s condition. If multiple bystanders are present, the rescuer should specifically designate one person to make the call and remain on the line with the dispatcher. This delegation ensures the call is placed promptly while the primary rescuer prepares to administer aid.
During this step, the rescuer should also ask a second bystander to locate an Automated External Defibrillator (AED) if one is known to be nearby. Many public locations maintain AEDs, and the device’s prompt use can significantly increase survival chances for a person experiencing sudden cardiac arrest.
The Third C: Care
With the scene secured and professional help summoned, the rescuer transitions into the physical delivery of aid, which is the final component of the framework. This step involves initiating cardiopulmonary resuscitation to artificially circulate blood and oxygen until the EMS team arrives. The primary element of resuscitation is chest compressions, which mechanically pump the blood.
For an adult, compressions should be delivered hard and fast, pressing down on the center of the chest to a depth of about 2 to 2.4 inches. The rate of compressions should be between 100 to 120 beats per minute, which is approximately the tempo of the song “Stayin’ Alive.” Allowing the chest to fully recoil between compressions is important to ensure the heart refills with blood.
Trained rescuers should combine compressions with rescue breaths, performing cycles of 30 compressions followed by two breaths. The rescue breaths aim to introduce oxygen back into the lungs, which is then circulated by the chest compressions. For those not trained or unwilling to perform rescue breaths, continuous hands-only chest compressions should be maintained until emergency responders or the AED take over.