Cardiopulmonary resuscitation (CPR) is an emergency procedure that can help save a life when someone’s breathing or heart has stopped. Administering effective chest compressions is a core component of CPR, and correct hand positioning is crucial for both the effectiveness of these compressions and to minimize the risk of injury to the individual receiving aid. Understanding where to position hands for different age groups ensures that compressions are delivered appropriately, helping to circulate oxygen-rich blood to the brain and other vital organs until professional medical help arrives. This knowledge can make a significant difference in an emergency situation. Compressions should be delivered at a rate of 100 to 120 per minute across all age groups.
Locating Hand Position for Adults
For adults requiring CPR, proper hand placement is centered on the lower half of the breastbone, also known as the sternum. The rescuer should kneel beside the individual and place the heel of one hand in the middle of the chest, specifically on the lower half of the sternum. This area is generally between the nipples. The heel of the other hand is then placed directly on top of the first hand, with fingers interlaced or lifted to ensure they do not touch the chest.
Maintaining correct body mechanics is also important for effective compressions. The rescuer’s shoulders should be positioned directly above their hands, and arms should be kept straight with elbows locked. This posture allows the rescuer to use their upper body weight to deliver compressions, rather than just arm strength, ensuring sufficient depth. Compressions should be delivered straight down, typically to a depth of at least 2 inches (5 cm) but no more than 2.4 inches (6 cm).
Rescuers should avoid the xiphoid process, which is the small, cartilaginous tip at the very bottom of the sternum. Pressing on this area or the ribs can cause injury to underlying organs like the liver or diaphragm. Allowing the chest to fully recoil after each compression is also necessary to permit the heart to refill with blood.
Locating Hand Position for Children
When performing CPR on a child, typically aged 1 year to puberty, the hand positioning remains on the center of the chest, over the lower half of the breastbone. The primary difference from adult CPR often lies in the force and number of hands used for compressions. A single hand may be sufficient for smaller children, while two hands might be necessary for larger children or if the rescuer needs to ensure adequate depth.
The heel of one hand is placed in the center of the child’s chest, similar to adult placement. If a second hand is used, it can be placed on top of the first, with fingers interlocked and off the chest. The compression depth for children should be approximately 2 inches (5 cm), or about one-third the depth of the chest. This adaptation ensures that compressions are effective without being overly forceful for the child’s smaller body.
Regardless of whether one or two hands are used, the focus remains on delivering firm, consistent compressions. Adapting to the child’s size and ensuring proper depth are important for effective pediatric CPR.
Locating Hand Position for Infants
For infants, defined as those under 1 year of age, the hand positioning for CPR is distinct and requires specific attention to detail. Compressions are administered in the center of the chest, typically just below an imaginary line drawn between the nipples. The preferred method for a single rescuer involves using two fingers, usually the index and middle fingers, or the middle and ring fingers.
These two fingers are placed perpendicular to the infant’s chest, ensuring pressure is applied directly onto the breastbone. The compression depth for infants is about 1.5 inches (4 cm), or approximately one-third the depth of the infant’s chest. For two rescuers, or if the rescuer’s hands are large enough, the two-thumb encircling hands technique can be used, where both thumbs compress the chest while the fingers encircle the infant’s back for support.
Supporting the infant’s head and neck is important, especially if they are not already on a firm, flat surface. The compressions should be gentle but firm.