What is Hands Only CPR (Compression Only CPR and How to Use It

Last updated:
May 30, 2023

CPR is a crucial intervention that can significantly increase the chances of survival and minimize the risk of irreversible damage to the brain and other organs. In recent years, a new approach to CPR known as "hands-only CPR" or compression only CPR has gained recognition and popularity.

Hands-only CPR simplifies the technique by focusing solely on chest compressions without the inclusion of rescue breaths. This approach eliminates potential barriers to performing CPR, such as concerns about mouth-to-mouth contact, and encourages more people to take action in emergency situations.

In this article, we will explore the concept of hands-only CPR, its effectiveness, and how it can be a valuable tool in saving lives. We will discuss its benefits, proper technique, and when hands-only CPR is recommended. 


What Is Hands Only CPR or Compression Only CPR?

Hands-only CPR, also known as compression-only CPR is a type of cardiopulmonary resuscitation (CPR) used in emergencies when a person has stopped breathing, or their heart has stopped beating. This type of CPR involves only chest compressions and no rescue breaths. Instead of providing rescue breaths, hands-only CPR focuses solely on compressions to circulate blood and deliver oxygen to the vital organs. It is recommended for use by lay rescuers who are not trained in traditional CPR.

Hands only CPR is an effective way to help someone in cardiac arrest. It helps to circulate oxygen-rich blood throughout the body and can help to restart the heart. Studies have shown that compression-only CPR is just as effective as traditional CPR in helping to save the life of someone in cardiac arrest.

By knowing how to perform hands-only CPR or compression only CPR, you can play a crucial role in sustaining circulation and buying precious time until professional medical help arrives, potentially improving the chances of survival for someone experiencing cardiac arrest.


Why would you use Hands-Only CPR?

Given that 70 percent of out-of-hospital cardiac arrests occur in residential settings, there is a high probability that you may find yourself in a situation where you need to perform Hands-Only CPR or Compression Only CPR in an effort to save the life of a loved one. Research has demonstrated that bystander-initiated Hands-Only CPR is equally effective as traditional CPR involving breaths, particularly within the initial few minutes of an out-of-hospital sudden cardiac arrest involving an adult victim.

What Are The Benefits Of Using Hands Only CPR?

Hands-only CPR offers several benefits that make it a valuable life-saving technique:


Increased Chances of Survival

Hands-only CPR, even if it's not performed perfectly, greatly increases a person's chances of survival. The critical factor in cardiac arrest is maintaining blood circulation and oxygen delivery to vital organs, and hands-only CPR achieves this by focusing on continuous chest compressions. By initiating immediate chest compressions, bystanders can buy crucial time for the person in cardiac arrest until professional help arrives.


Simplicity and Ease of Learning

Hands-only CPR is faster and easier to learn compared to traditional CPR, which involves a combination of chest compressions and rescue breaths. The simplified technique eliminates the need for rescue breaths, removing potential barriers and making it more accessible to a wider range of people. The focus on chest compressions allows for a quicker response in emergency situations, as it is a simpler skill to acquire and remember.


Pandemic-Safe Intervention

During times of infectious disease outbreaks, such as the COVID-19 pandemic, the risk of transmitting respiratory infections through rescue breaths becomes a concern. Hands-only CPR eliminates the need for rescue breaths, making it a safer option for bystanders to provide assistance without direct mouth-to-mouth contact. This aspect is particularly relevant in maintaining personal safety and reducing the risk of exposure to infectious agents.


By emphasizing the importance of immediate action, simplifying the technique, and removing barriers to bystander intervention, hands-only CPR empowers individuals to take life-saving measures in emergency situations. Its effectiveness, ease of learning, and pandemic-safe nature make it a valuable tool in increasing survival rates for sudden cardiac arrest.


What Is The Purpose Of Hands only CPR?

The purpose of hands-only CPR is to provide immediate and effective chest compressions to a person experiencing sudden cardiac arrest. It is appropriate to use hands-only CPR when a bystander encounters an adult who suddenly collapses and is unresponsive.


What Is The Difference Between Hands only CPR and Traditional CPR?

  • Hands-only CPR focuses solely on chest compressions, while traditional CPR includes both chest compressions and rescue breaths.
  • Hands-only CPR eliminates the need for mouth-to-mouth resuscitation, making it more appealing to bystanders who may feel uncomfortable or hesitant about performing rescue breaths.
  • Traditional CPR involves a compression-to-ventilation ratio of 30:2, while hands-only CPR consists of continuous chest compressions without interruptions for rescue breaths.
  • Hands-only CPR is simpler and easier to learn, increasing the likelihood that bystanders will intervene in an emergency situation.
  • Hands-only CPR has been found to be equally effective as traditional CPR for witnessed adult cardiac arrests in non-hospital settings.

How to Save a Life with Chest Compression Only CPR?

When someone goes into cardiac arrest, it is essential to start chest compressions immediately to preserve the brain and other vital organs. Without treatment, death can occur in minutes. Chest compressions mimic the heart's pumping action and help keep blood flowing throughout the vital organs. Without this blood flow, the brain will start to die in 6 to 8 minutes. That is why it is so important to perform continuous chest compressions before the emergency medical services arrive; the sooner, the better.

What Are The Correct Steps For Providing Hands Only CPR?

Before performing hands-only CPR, it's important to assess the situation. Check the scene for safety and determine if the person is unresponsive and not breathing normally.

1. Call 911

If there are bystanders around, shout for someone to call emergency services (911 or local emergency number) and get an AED, if available. If you are alone,  you can also call from your cell phone on speakerphone as you begin compressions.


2. Perform Chest Compressions

Once you shout for help, the next steps for providing hands-only CPR are to position the person, place your hands on the center of their chest, and start delivering chest compressions at the recommended rate and depth. 

  • Hand placement:  Place the heel of one hand on the center of the chest, between the nipples. Place the other hand on top of the first hand, interlocking the fingers.
  • Compression depth: Push down on the chest, using your body weight to compress at least 2 inches (5 centimeters) but not more than 2.4 inches (6 centimeters).
  • Compression rate: When you do hands-only CPR, you should perform 100 to 120 chest compressions each minute. To maintain the rhythm, you can perform compressions to the beat of the song "Stayin' Alive" by the Bee Gees.
  • Allow the chest to recoil: After each compression, allow the chest to fully recoil without lifting your hands off the chest.

Continue delivering chest compressions at the correct rate and depth until emergency medical services arrive, an AED is available to use, or until you are too exhausted to continue. Once help arrives, inform the healthcare professionals about what happened and the actions you took.


How many chest compressions per minute?

According to the AHA guidelines for resuscitation, Cardiopulmonary Resuscitation should be performed with 5 cycles of 30 compression and 2 rescue breaths in about 2 minutes. If compressions only are being done (hands-only CPR), aim for 100-120 compressions per minute. Continue until the patient recovers — starts moving and breathing normally, coughing, or talking. At this point, they should be placed in the recovery position. If CPR becomes too tiring, interruption should be minimal to maintain effective compressions.

When You Should Use Hands Only CPR?

Hands-only CPR is recommended in the following situations:

  1. For an adult or adolescent victim (over 8 years old) who suddenly collapses and is unresponsive.
  2. When you are untrained or uncomfortable with performing rescue breaths.
  3. In cases where it is not feasible or safe to perform mouth-to-mouth breathing, such as during the COVID-19 pandemic or in situations where you are uncertain about the victim's condition or the presence of an infectious disease.

It's important to note that for infants and children, traditional CPR with both compressions and rescue breaths is still recommended. However, if you are untrained or unable to perform rescue breaths, hands-only CPR can still be attempted until help arrives.


What Is The Role Of Hands Only CPR In The Chain Of Survival

Hands-only CPR plays a crucial role in the chain of survival, which is a series of steps that aim to improve a person's chances of survival during a cardiac arrest. Its primary role is to provide immediate chest compressions to maintain blood circulation until professional medical help arrives. By starting hands-only CPR promptly, bystanders can bridge the gap between the onset of cardiac arrest and the arrival of emergency medical services.

Hands-only CPR has been proven to be highly effective in increasing survival rates. Research has shown that early initiation of hands-only CPR can double or even triple the chances of survival for a person experiencing cardiac arrest. According to the American Heart Association, the survival rates of out-of-hospital cardiac arrests can be significantly improved when bystanders perform hands-only CPR before the arrival of emergency medical services.

In fact, studies have shown that the simplicity and ease of hands-only CPR make it more likely to be performed by bystanders. Many people feel more confident and willing to provide chest compressions rather than incorporating rescue breaths. By focusing on continuous, uninterrupted chest compressions, hands-only CPR minimizes the delay in providing vital circulatory support to the person in need.

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Chain of Survival

Can Hands Only CPR Be Performed Without Any Formal Training?

Yes, hands-only CPR can be performed without any formal training. The technique is designed to be simple and easy to learn, making it accessible to anyone who witnesses a cardiac arrest emergency. Bystanders who are untrained or not confident in performing traditional CPR with rescue breaths can still provide valuable assistance by performing hands-only CPR.


Does learning Hands-Only CPR increases the chance of a bystander taking action in a cardiac emergency?

Yes, a majority of Americans (70 percent) often experience a sense of helplessness when faced with a cardiac emergency due to their lack of knowledge in administering CPR or their fear of causing harm to the victim. The American Heart Association highlights that individuals are more likely to recall the appropriate compression rate when trained to the rhythm of well-known songs such as the disco classic "Stayin' Alive" or other familiar tunes that align with the recommended 100 to 120 beats per minute, which corresponds to the rate at which chest compressions should be performed during CPR.


Can music help me Learn Hands Only CPR?

Music can be an excellent educational aid in various scenarios, particularly when preparing for emergencies. When performing CPR, it is crucial to maintain a compression rate of 100 to 120 compressions per minute. The rhythm of the song "Stayin' Alive" aligns perfectly with this recommended pace, and studies indicate that individuals are more likely to retain the correct tempo when trained to the beat of a familiar tune.

From Where Can I Learn The Proper Technique For Hands Only CPR?

You can learn the proper technique for hands-only CPR from various sources. Here are some options:

  • Local CPR training centers: Contact local hospitals, community centers, or fire departments to inquire about CPR training courses. These organizations often offer hands-on training sessions where you can learn the proper technique under the guidance of certified instructors.
  • American Heart Association (AHA): The AHA provides CPR training programs, including hands-only CPR, through their authorized training centers. You can visit their website or contact their local affiliates to find courses in your area.
  • Online resources: Several reputable organizations and websites offer online CPR training, including hands-only CPR. These courses typically include instructional videos, step-by-step guides, and practice simulations to help you learn and practice the technique at your own pace.

Getting Your CPR Certification with Online Classes

Although CPR is such a valuable skill, many people never learn it because they feel the classes will be time-consuming and expensive. Others may have gotten a certification and let it expire so that they no longer feel confident in their skills.

However, online CPR training provides a convenient and easy way to become CPR certified, so there is never a good reason not to take CPR classes or let your CPR certification expire. These classes allow you to learn from the comfort of your own home and go at your own pace when it comes to learning.

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