This is the most important skill of the whole course. If a person does not respond and is not breathing normally, you assume cardiac arrest and start immediately. Searching for a pulse is for professionals – no response and no normal breathing is enough.
Cardiopulmonary resuscitation
The rhythm is always 30 : 2 – 30 compressions, 2 breaths.
Practical tips: compress on a firm surface, arms straight, vertically from above, both hands on top of each other, fingers interlocked. If you’re unsure about the breaths, simply keep compressing without stopping – uninterrupted chest compressions are far better than none. Every interruption lowers the chance of survival and should last no more than about 10 seconds.
Defibrillator (AED)
As soon as an AED is available, you switch it on and follow the voice prompts exactly. You stick the electrodes onto the bare chest; the device analyses the heart rhythm itself and only releases a shock when needed. An AED cannot be used incorrectly by a layperson – the devices are found in many public places. While the pads are applied, chest compressions should continue if possible.
Choking: foreign body in the airway
If someone swallows the wrong way and the airway is blocked, fast, stepwise action counts. The key question first: can the person still cough?
Let them cough if possible – otherwise back blows and Heimlich alternating.
How to do it: bend the upper body forward and give firm blows with the heel of your hand between the shoulder blades. If that doesn’t help, stand behind the person and perform the Heimlich manoeuvre – wrap both arms around the upper abdomen from behind, form a fist, hold it with the other hand and pull sharply backwards and upwards, up to five times. Back blows and abdominal thrusts alternate until the foreign body is out or the person becomes unconscious. After a successful removal the person should still be examined by a doctor.
Resuscitation in children and infants
It follows the same basic idea as in adults, with a few important differences. As children almost always collapse from lack of oxygen, you start with five breaths before compressing.
| Feature | Infant (< 1 yr) | Child (1 yr–puberty) | Adult |
|---|---|---|---|
| Start | 5 breaths first | 5 breaths first | Compress directly |
| Technique | 2 fingers | 1 heel of hand | 2 heels of hand |
| Depth | approx. 1/3 (~4 cm) | approx. 1/3 (~5 cm) | 5–6 cm |
| Ratio (lay) | 30 : 2 | 30 : 2 | 30 : 2 |
Rate for everyone: 100–120 per minute. Trained helpers use 15:2 in children and infants. You also use an AED on children – with paediatric pads or child mode if available. Infants and small children are usually too small for the recovery position; in the first years of life the prone position with the head turned to the side is recommended.