Cardiopulmonary Resuscitation (CPR) is a life-saving technique used when someone’s heart has stopped beating. Hands-Only CPR (HOCPR) is a streamlined approach designed for immediate bystander intervention. This method eliminates rescue breaths, focusing entirely on chest compressions to maintain life until professional help arrives. HOCPR is promoted for use by untrained or minimally trained lay rescuers who witness an adult or teenager suddenly collapse, encouraging immediate action in a cardiac emergency.
The Core Objective: Maximizing Immediate Blood Flow
The primary goal of Hands-Only CPR is to maintain the circulation of oxygenated blood to the brain and heart muscle. In the first few minutes after sudden cardiac arrest, the victim’s blood contains sufficient oxygen. The immediate problem is the heart’s inability to pump the blood that is already oxygenated, not a lack of oxygen. Chest compressions act as an artificial pump, manually forcing this oxygen-rich blood through the circulatory system. Continuous, high-quality compressions are prioritized because any pause significantly reduces blood pressure and flow to the brain. This sustained flow helps prevent tissue damage, buying precious time until emergency medical services arrive.
Simplified Technique and Performance
The Hands-Only technique simplifies the response to a cardiac emergency into two steps: calling emergency services and performing continuous chest compressions. This simplified process is easier to teach, remember, and execute under the stress of an emergency situation. The exclusion of mouth-to-mouth ventilation removes a significant psychological barrier for many potential rescuers, such as concerns about disease transmission.
To be effective, compressions must be delivered hard and fast on the center of the chest. The recommended rate is between 100 and 120 compressions per minute, often equated to the beat of the song “Stayin’ Alive.” For an adult, compressions should push straight down at least 2 inches, but no more than 2.4 inches, allowing the chest to fully recoil between each push. Maintaining this specific rate and depth ensures enough pressure is generated to effectively circulate the blood.
When Hands-Only CPR is the Recommended Choice
Hands-Only CPR is strongly recommended for bystanders who witness the sudden collapse of an adult or teen. In these scenarios, the cause is typically sudden cardiac arrest, which is an electrical problem in the heart, not a primary breathing issue.
A major purpose of HOCPR is reducing rescuer hesitation. The complexity of conventional CPR often causes untrained bystanders to delay action. Eliminating the mouth-to-mouth component encourages immediate intervention, and research indicates that survival rates double or triple when a victim receives immediate bystander CPR. Speed is paramount, as the chance of survival decreases by approximately 10 percent for every minute that passes without effective compressions.
When Conventional CPR is Still Necessary
While Hands-Only CPR is effective for sudden cardiac arrest, Conventional CPR, which includes both compressions and rescue breaths, remains necessary when the underlying problem is respiratory. Victims who collapsed due to a lack of oxygen require the immediate addition of oxygen to their system. This is often the case when the victim was not getting enough oxygen before the heart stopped.
Specific scenarios that demand rescue breaths include infants and children, as their cardiac arrests are most often the result of respiratory failure. Victims of drowning, drug overdose, or prolonged respiratory arrest also require ventilation because their blood oxygen levels are critically low. In these cases, the traditional 30 compressions to 2 breaths cycle is necessary to introduce fresh oxygen into the lungs while simultaneously circulating that newly oxygenated blood.