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A cardiac arrest is when someone's heart suddenly stops beating, and their breathing is abnormal or has stopped.

Without quick action, the person will die. If you see someone collapsed and not breathing normally, you need to act fast so they can have the best chance of survival.

To learn how to perform CPR, watch our short animation video below. We also have versions of this animation in a range of language translations.

The steps you need to take to do CPR

Before you approach the person who has collapsed, check your surroundings for danger.
1. Shout for help. 2. Look and listen for signs of normal breathing.

Look for the rise and fall of their chest.
3. Call 999.

Put the phone on loudspeaker and tell them you are with someone who is not breathing.
4. Fetch a defibrillator if you can.

The ambulance call handler will tell you where the nearest automated external defibrillator (AED) is. If someone is with you, ask them to fetch it and bring it back. Do not leave the person if you are on your own.
5. Start chest compressions:

interlock your fingers

place your hands in the centre of the chest

push down hard and then release twice per second, and don't stop. The ambulance call handler will help you.

6. If you have a defibrillator, switch it on and follow the instructions.

A defibrillator will tell you exactly what to do. Visit our defibrillator page for more information about them.
7. Continue CPR until:

the AED asks you to pause while it reanalyses and gives another shock if needed

a paramedic arrives and tells you what to do

the person shows signs of life.

By developing the skills and confidence to follow these simple steps, you could be a lifesaver in an emergency.

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A cardiac arrest is when someone's heart suddenly stops beating, and their breathing is abnormal or has stopped. Without quick action, the person will die. If you see someone collapsed and not breathing normally, you need to act fast so they can have the best chance of survival.

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Metronome 120 BPM - For CPR Training - Chest Compression Rate #listenable

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The Chokeables: How to save a choking baby - St John Ambulance

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Paediatric advanced life support Guidelines

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Guidelines for treating children who require advanced life support.

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Those with a duty to respond to paediatric emergencies (usually healthcare professional teams) should use the following sequence:

If the child responds by answering or moving:

If the child does not respond:

Shout for help.

In cases where there is more than one rescuer, a second rescuer should call 999 (outside hospital) to summon emergency medical services (EMS) or call 2222 if in an NHS hospital to summon the clinical emergency team immediately. If calling 999 preferably use the speaker function of a mobile phone.

Turn the child onto their back and open the airway using head tilt and chin lift:

Place your hand on their forehead and gently tilt their head back.

With your fingertip(s) under the point of the child's chin, lift the chin. Do not push on the soft tissues under the chin as this may block the airway.

If you still have difficulty in opening the airway, try the jaw thrust method: place the first two fingers of each hand behind each side of the child's mandible (jawbone) and push the jaw forward (towards you).

Have a low threshold for suspecting injury to the neck. If you suspect this, try to open the airway using jaw thrust alone. If this is unsuccessful, add head tilt gradually until the airway is open. Establishing an open airway takes priority over concerns about the cervical spine.

Keeping the airway open, look, listen, and feel for abnormal/absent breathing by putting your face close to the child's face and looking along the chest whilst simultaneously looking for signs of life.

Look for chest movements:

Listen at the child's nose and mouth for breath sounds.

Feel for air movement on your cheek.

In the first few minutes after cardiac arrest a child may be taking infrequent, noisy gasps. Do not confuse this with normal breathing.

Look, listen, and feel for no more than 10 seconds before deciding - if you have any doubts whether breathing is normal, act as if it is not normal.

Simultaneously look for signs of life (these include any movement, coughing, or normal breathing).

(Note: Studies have shown how unreliable feeling for a pulse is in determining presence or absence of a circulation even for trained paediatric healthcare workers, hence the importance of the need to look for signs of life. However, if a healthcare worker wishes to also check for a pulse this should be done simultaneously with the breathing assessment).
If the child IS breathing normally:

If the child's breathing is abnormal or absent

Give 5 initial rescue breaths.

Although rescue breaths are described here, it is common in healthcare environments to have access to bag-mask devices and providers trained in their use should use them as soon as they are available. In larger children when BMV is not available, competent providers can also use a pocket mask for rescue breaths.

While performing the rescue breaths, note any gag or cough response to your action. These responses, or their absence, will form part of your ongoing assessment of 'signs of life'

Rescue breaths for an infant:

Ensure a neutral position of the head (as an infant's head is usually flexed when supine, this may require some gentle extension) and apply chin lift.

Take a breath and cover the mouth and nose of the infant with your mouth, making sure you have a good seal.

If the nose and mouth cannot both be covered in the older infant, the rescuer may attempt to seal only the infant's nose or mouth with their mouth (if the nose is used, close the lips to prevent air escape).

Blow steadily into the infant's mouth and nose over 1 second sufficient to make the chest rise visibly. This is the same time period as in adult practice.

Maintain head position and chin lift, take your mouth away, and watch for their chest to fall as air comes out.

Take another breath and repeat this sequence four more times.

Rescue breaths for a child over 1 year:

Ensure head tilt and chin lift; extending the head into 'sniffing' position.

Pinch the soft part of the nose closed with the index finger and thumb of your hand on their forehead.

Open the mouth a little but maintain the chin lift.

Take a breath and place your lips around the mouth, making sure that you have a good seal.

Blow steadily into their mouth over 1 second sufficient to make the chest rise visibly.

Maintaining head tilt and chin lift, take your mouth away and watch for the chest to fall as air comes out.

Take another breath and repeat this sequence four more times.

Identify effectiveness by seeing that the child's chest has risen and fallen in a similar fashion to the movement produced by a normal breath.

For both infants and children, if you have difficulty achieving an effective breath, the airway may be obstructed:

1. If there is only one rescuer, with a mobile phone, they should call for help (and activate the speaker function) immediately after the initial rescue breaths. Proceed to the next step while waiting for an answer. If no phone is readily available perform one minute of CPR before leaving the child.

2. In cases where paediatric BLS providers are unable or unwilling to start with ventilations, they should proceed with compressions and add ventilations into the sequence when able (another provider, equipment available).

Following the rescue breaths, if you are confident that you can detect signs of life:

Following the rescue breaths, if there are no signs of life or if you are unsure:

Start good quality chest compressions.

Rate: 100-120 min⁻¹ for both infants and children.

Depth: depress the lower half of the sternum by at least one third of the anterior-posterior dimension of the chest (which is approximately 4 cm for an infant and 5 cm for a child).

Compressions should never be deeper than the adult 6 cm limit (approx. an adult thumb's length).

Release all pressure on the chest between compressions to allow for complete chest recoil and avoid leaning on the chest at the end of a compression.

Allow adequate time for chest recoil to occur (approximately 50% of the whole cycle should be the relaxation phase, i.e., from the start of one compression to the next).

Chest compression pauses should be minimised so that 80% or more of the CPR cycle is comprised of chest compressions.

For all children, compress the lower half of the sternum:

To avoid compressing the upper abdomen, locate the xiphisternum by finding the angle where the lowest ribs join the sternum (breastbone).

Compress the sternum one finger's breadth above this.

After each compression, release the pressure completely then repeat at a rate of 100-120 min⁻¹.

Allow the chest to return to its resting position before starting the next compression.

After 15 compressions, tilt the head, lift the chin, and give rescue breaths.

Continue compressions and breaths in a ratio of 15:2.

Perform compressions on a firm surface.

The best method for compression varies slightly between infants and children.

Chest compression in infants:

Preferably use a two-thumb encircling technique for chest compression in infants - be careful to ensure complete chest recoil after each chest compression. Single rescuers might alternatively use a two-finger technique.

The encircling technique:

Place both thumbs flat, side-by-side, on the lower half of the sternum (as above), with the tips pointing towards the infant's head.

Spread the rest of both hands, with the fingers together, to encircle the lower part of the infant's rib cage with the tips of the fingers supporting the infant's back. Press down on the lower sternum with your two thumbs to depress it at least one-third of the depth of the infant's chest, approximately 4 cm.

For small infants, you may need to overlap your thumbs to provide effective compressions.

Two finger technique: Compress the lower sternum with the tips of two of your fingers (index and middle fingers) by at least one-third of the depth of the infant's chest, approximately 4cm.

Chest compression in children aged over 1 year: Note: Do not interrupt CPR at any moment unless there are clear signs of life (movement, coughing, normal breathing). Two or more rescuers should alternate who is performing chest compressions frequently; the compressing rescuer should switch hands (the hand compressing, the hand which is on top) or the technique (one to 2-handed) to avoid fatigue. Continue resuscitation until:
When to call for assistance

It is vital for rescuers to get help as quickly as possible when a child collapses:

In cases where there is more than one rescuer, a second rescuer should call the EMS immediately upon recognition of unconsciousness, preferably using the speaker function of a mobile phone.

If there is only one rescuer, with a mobile phone, they should call help first (and activate the speaker function) immediately after the initial rescue breaths. Proceed to the next step while waiting for an answer.

If no mobile phone is available and more than one rescuer is available, one (or more) person starts resuscitation while another goes for assistance.

If only one rescuer is present without a mobile phone, undertake resuscitation for about 1 minute before going for assistance. To minimise interruptions in CPR, it may be possible to carry an infant or small child whilst summoning help.

The only exception to performing 1 minute of CPR before going for help is in the unlikely event of a child with a witnessed, sudden collapse when the rescuer is alone with no phone and primary cardiac arrest is suspected. In this situation, a shockable rhythm is likely and the child may need defibrillation. Seek help immediately if there is no one to go for you.

Paediatric BLS modified
Adult sequence with paediatric modifications

Rescuers who have been taught adult BLS, and have no specific knowledge of paediatric resuscitation, should use the adult sequence.

The paediatric modifications to adult CPR should be taught to those who care for children but are unlikely to have to resuscitate them.

Give 5 rescue breaths before starting chest compression.

If you are on your own, perform CPR for 1 min before going for help.

Compress the chest by at least one-third of its depth, approximately 4 cm for an infant and approximately 5 cm for an older child. Use both thumbs or two fingers for an infant under 1 year; use one or two hands for a child over 1 year as required to achieve an adequate depth of compression.

The compression rate should be 100-120 min⁻¹.

Dispatcher-directed CPR

Bystander CPR should be started in all cases when feasible. The EMS dispatcher has a crucial role in assisting untrained bystanders to recognise cardiac arrest and provide CPR. When bystander CPR is already in progress at the time of the call, dispatchers may only provide instructions when asked for, or when issues with knowledge or skills are identified.

The steps of the algorithm for paediatric dispatcher-assisted CPR are very similar to the paediatric BLS algorithm. To decrease the number of changes in rescuer position, a 30:2 C:V ratio might be preferable for a lone rescuer. If bystanders cannot provide rescue breaths, they should proceed with chest compressions only. A child or infant is far more likely to be harmed if the bystander does nothing.

Recovery position

For children and infants with a decreased level of consciousness who do not meet the criteria for the initiation of rescue breathing or chest compressions (CPR), the recovery position may be recommended. The following describes one method of achieving a left lateral position:

Kneel beside the child and make sure that both legs are straight.

Place the arm nearest to you out at right angles to the body, elbow bent with the hand palm uppermost.

Bring the far arm across the chest, and hold the back of the hand against the child's cheek nearest to you.

With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot on the ground.

Keeping the hand pressed against the cheek, pull on the far leg to roll the child towards you onto their side.

Adjust the upper leg so that both hip and knee are bent at right angles.

Tilt the head back to make sure the airway remains open.

Adjust the hand under the cheek if necessary, to keep the head tilted and facing downwards to allow liquid material to drain from the mouth.

Check breathing regularly (at least every minute).

Ensure the position is stable. In an infant, this may require the support of a small pillow or a rolled-up blanket placed behind their back to maintain the position.

It is important to maintain a close check on all unconscious children until the EMS arrives to ensure that their breathing remains normal.

Avoid any pressure on the child or infant's chest that may impair breathing and regularly turn the unconscious child or infant over onto their opposite side to prevent pressure injuries whilst in the recovery position (i.e. every 30 minutes).

In certain situations, such as when the child or infant is breathing spontaneously but requires airway management or when the child has a traumatic injury, the recovery position is not recommended. In these circumstances:

Keep the patient flat, maintain an open airway by either continued head tilt and chin lift or jaw thrust.

For trauma victims, leave the child or infant lying flat and open and maintain the airway using a jaw thrust, taking care to avoid spinal movement.

Automated external defibrillators (AEDs)

Paediatric BLS in case of traumatic cardiac arrest (TCA)

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Paediatric basic life support Guidelines

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Guidelines for healthcare professionals and the general public on giving CPR to a child in cardiac arrest.

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Allergic reactions are caused by the sudden release of chemicals, including histamine, from cells in the body. The release is triggered by the reaction between the immune system antibodies (called Immunoglobulin E or IgE) and the food or substance (known as an allergen) it has been exposed to.

The body will have been exposed to the allergen on a previous occasion, although the person may not have been aware of this at the time. On that earlier occasion, the allergen was wrongly identified as a threat and antibodies were made against it, which means that on the next exposure, a serious reaction may occur.

The mechanism is so sensitive that sometimes even tiny amounts of the allergen can cause an allergic reaction.

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Anaphylaxis is a very serious allergic reaction requiring emergency treatment. What are the symptoms? What to do in an emergency?

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your lips, mouth, throat or tongue suddenly become swollen

you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)

your throat feels tight or you're struggling to swallow

your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)

you suddenly become very confused, drowsy or dizzy

someone faints and cannot be woken up

a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised or itchy.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

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NHS information about anaphylaxis, including symptoms, when to get help, treatment and prevention.

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Explore our glossary of terms relating to anaphylaxis and serious allergies.

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Anaphylaxis is a severe, life-threatening allergic reaction. This is one of several allergy care pathways, which tell health professionals what they need to know in order to provide the best care possible.

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A cardiac arrest is when someone's heart suddenly stops beating, and their breathing is abnormal or has stopped.

Without quick action, the person will die. If you see someone collapsed and not breathing normally, you need to act fast so they can have the best chance of survival.

To learn how to perform CPR, watch our short animation video below. We also have versions of this animation in a range of language translations.

The steps you need to take to do CPR

Before you approach the person who has collapsed, check your surroundings for danger.
1. Shout for help. 2. Look and listen for signs of normal breathing.

Look for the rise and fall of their chest.
3. Call 999.

Put the phone on loudspeaker and tell them you are with someone who is not breathing.
4. Fetch a defibrillator if you can.

The ambulance call handler will tell you where the nearest automated external defibrillator (AED) is. If someone is with you, ask them to fetch it and bring it back. Do not leave the person if you are on your own.
5. Start chest compressions:

interlock your fingers

place your hands in the centre of the chest

push down hard and then release twice per second, and don't stop. The ambulance call handler will help you.

6. If you have a defibrillator, switch it on and follow the instructions.

A defibrillator will tell you exactly what to do. Visit our defibrillator page for more information about them.
7. Continue CPR until:

the AED asks you to pause while it reanalyses and gives another shock if needed

a paramedic arrives and tells you what to do

the person shows signs of life.

By developing the skills and confidence to follow these simple steps, you could be a lifesaver in an emergency.

# data[].attributes.attachment_link.description
A cardiac arrest is when someone's heart suddenly stops beating, and their breathing is abnormal or has stopped. Without quick action, the person will die. If you see someone collapsed and not breathing normally, you need to act fast so they can have the best chance of survival.

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Learn how to do CPR with our step-by-step videos.

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RevivR British Heart Foundation CPR Training

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RevivR British Heart Foundation CPR Training

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RevivR is a short, self-directed CPR training from British Heart Foundation, that could teach you how to save someone’s life.

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Do you have to give rescue breaths during CPR in an adult?

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Do you have to give rescue breaths during CPR in an adult?