Version control: This document is current with respect to the latest 2016 American Heart Association® Guidelines for CPR and ECC. These guidelines are current until they are replaced on October 21, 2020. If you are reading this page after October 21, 2020, please contact ACLS Training Center at for an updated document.

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Updated 2016 version

  1. Ensure that the environment around you is safe to work in
  2. If the victim is unresponsive get help by activating the EMS system
    1. If you are alone use a cell phone on speaker so that you can follow the instructions of the dispatcher while staying with the victim
  3. Check for NORMAL BREATHING (agonal or slow respirations do not count)
    1. If normal – activate the EMS system and stay with the patient monitoring respirations
    2. If no normal breathing but the patient has a pulse ventilate the patient using 1 breath every 3–5 seconds (12–20 breaths per minute)
      1. Compress the chest if pulse is less than 60/min and the patient has signs of poor perfusion
      2. If not already notified, call EMS after two minutes of intervention
      3. Continue rescue breathing and check pulses every 2 minutes. If at anytime there is no pulse, begin compressions immediately at a rate of 100–120 per minute
  4. No breathing AND no pulse
    1. If witnessed collapse – activate EMS and retrieve the AED
      1. CPR (1 rescuer) 30 compressions to 2 ventilations (2 rescuer 15 compressions to 2 ventilations
      2. Use the AED as soon as it is available
    2. If not witnessed collapse
      1. CPR (1 rescuer) 30 compressions to 2 ventilations (2 rescuer 15 compressions to 2 ventilations
      2. After about 2 minutes (if still alone) activate EMS and retrieve the AED
      3. Use the AED as soon as it is available
  5. AED arrives
    1. If shockable rhythm, shock and immediately begin compressions until prompted by the AED to again analyze
      1. Continue until help arrives or patient shows signs of life
    2. If nonshockable rhythm, resume CPR until prompted for the AED to analyze again
      1. Continue until help arrives or patient shows signs of life