To perform chest compressions on an adult:
- Position the victim flat on a firm surface with head at the same level as the heart. Open chest clothing.
- Kneel facing the victim's chest. Using your hand nearest the victim's legs, locate the center of the chest, between the nipples on the victim's breastbone. Place the heel of your hand on the mid chest (lower half breastbone/sternum). Then place your other hand on top. With shoulders back, straighten your arms, lean directly over the person, and lock your elbows.
- Use straight-down pressure through both arms to push breastbone down toward the spine, at least 2 in./5 cm. Push hard and fast at rate of 100/min.
- Release pressure after each compression, but don't let your hands come off the victim's chest. Do not pause between compressions. The compressions should be smooth, regular, and uninterrupted. Compression and relaxation time should be equal.
- After 30 compressions, breathe twice into the victim's mouth (each breath lasting 1 second).
- Using your fingers (not thumb), gently feel the carotid artery on the victim's neck for no more than 10 seconds to find a pulse. (To find the carotid artery, put two fingers on the victim's Adam's apple [larynx]. Slide your fingers to the side and direct them into the groove between the windpipe and the muscle at the side of the neck. This is where the carotid artery is located.) Gently feel for a pulse.
If pulse is present but there is no breathing - Perform Rescue Breathing (give the victim 2 full breaths (1 second each), taking your lips off the victim's mouth to inhale between each breath) at a rate of one breath every 5-6 seconds (10-12/min) until breathing is restored or help arrives.
Remember: If no pulse is present - and medical help has been called, continue Chest Compressions until automated external defibrillator (AED) arrives.