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What To Do When The Heart And Breathing Stops

[fa icon="calendar"] Apr 13, 2021 9:30:00 AM / by Calvin Leong





Cardiopulmonary resuscitation (CPR) is an emergency procedure that is done to help a person whose breathing or heartbeat has stopped (cardiac arrest). When the heart stops beating, blood flow to the brain and other vital organs also stops. Brain damage or death can occur if this is not treated within minutes. CPR squeezes the heart and moves blood and oxygen to the brain and lungs. CPR can save a life.

Adult CPR guidelines apply to any person who has reached puberty. Signs of puberty in males include facial or underarm hair. A sign of puberty in females is breast development. Adult CPR is based on the C-A-B sequence:


  • C - Chest compressions.
  • A - Airway.
  • B - Breathing.


If an automated external defibrillator (AED) is available, use it during CPR. An AED is a portable electrical device that can deliver an electric shock (if necessary) to restart the heart or to return the heartbeat to normal. This process is called defibrillation. If an AED becomes available at any time, use it immediately.

The best way to learn CPR is to take a certified training class. Look for a class in your community. Almost anyone can learn to do CPR.

What should I do first?

If you see a person who seems to be unconscious and is not breathing, or is only gasping, take the following steps:

  1. Make sure the area is safe


  • Quickly look around the area where the person is located. Go to help the person only if the area seems safe to enter.
  • If the person is in immediate danger, try to carefully move the person away from the area.


  1. Check for a response


  • Firmly tap the person on a shoulder and loudly ask if he or she is okay.
  • Watch the person's face and chest for five to ten seconds to see if he or she is breathing.
  • If you are by yourself, shout for help to see if someone is nearby.


  1. Call emergency services


  • If the person does not respond, and he or she is not breathing or is only gasping, call emergency services (999 in Malaysia) and then start CPR. If calling from a cell phone, use the speakerphone function to keep your hands free.
    • If another person is nearby, ask that person to call emergency services and look for an AED while you start CPR.
  • If the person responds and is breathing normally but is ill or injured, call emergency services and wait for help. Follow the operator's instructions over the phone. While you wait, check the person frequently.
    • If another person is nearby, have that person call emergency services and look for an AED while you wait with the ill or injured person.


  1. Begin CPR


  • Start chest compressions immediately if the person does not respond to you, and:
    • The person is not breathing.
    • You are not sure if the person is breathing.
    • The person is gasping (moving his or her mouth to breathe but there is no chest movement).
  • Remember the C-A-B sequence: chest compressions, airway, and breathing.
  • If you have an AED, use it right away by turning it on and following its directions.



First aid course on white isolated background

How do I perform CPR?

Position the person

The person should be lying on a firm, flat surface, facing up. You may need to carefully roll the person into this position.

C - Chest compressions

To perform chest compressions, take the following steps:

  1. Kneel next to the person's chest.
  2. Place the heel of one of your hands in the middle of the person's chest, between the nipples.
  3. Place the heel of your other hand on top of the first hand so that your hands overlap, or use just one hand if the person is small.
  4. Push down until the chest moves down at least two inches (five cm), or one-third the depth of the chest.
  5. Let the chest rise up completely to its normal position before the next compression. Do not lean on the chest, especially between compressions.
  6. Do compressions very quickly, at a rate of 100–120 per minute. Count the compressions while you do them. Focus on doing compressions "hard and fast."

Do compressions at a consistent rhythm, with no interruptions, until the 999 operator provides other instructions. If you have an AED, follow its instructions.

A - Airway

Opening the airway prepares the person to receive rescue breaths. You should only open the airway if you are trained in compression and airway CPR. Be careful when moving the person's head and neck, especially if you think the person is injured.

Remember, "head tilt, chin lift":

  1. Place one hand on the person's forehead and push slightly with your palm to tilt the head back.
  2. Place the fingers of your other hand under the bony part of the person's lower jaw and gently lift the chin.
  3. Pinch the person's nose closed.

B - Breathing

If you are trained in compression and airway CPR, give the person rescue breaths by taking the following steps:

  1. Put your mouth over the person's mouth. Use a CPR barrier if you have one available. Make a good seal with your mouth so that all of the air that you exhale goes into the person's mouth.
  2. Exhale two breaths into the person's mouth. Each breath should take about 1 second.
  3. Make sure the person's chest rises when you exhale. If the chest does not rise, reposition the head and try again.

If you are by yourself, open the airway and give two rescue breaths after every 30 chest compressions. If you cannot give rescue breaths, you may do chest compressions only (compression-only CPR or hands-only CPR).


Perform defibrillation with an AED

Use an AED as soon as one becomes available. If there are two people performing CPR, one person should continue CPR while the second person prepares to use the AED. To use the AED, take the following steps:

  1. Turn on the AED and follow its directions. The AED will show where to attach the pads to the person's chest.
  2. The AED will automatically determine whether you need to give the person a shock. The AED will provide directions on how to do this. If a shock is needed:
    • Make sure that no one is touching the person before you give the shock. Right before the shock, loudly say, "clear" and look to be sure that no one is touching the person.
    • The AED will deliver a shock; follow the steps that it provides. You may have to push the "shock" button on the machine.
    • After one shock is delivered, continue to perform CPR. The AED will instruct you when to give another shock or when to check the person's heart rhythm.
    • Continue CPR and defibrillation until the person starts breathing normally or until medical personnel take over.
  3. If it is not possible or necessary to deliver a shock, continue CPR until medical help arrives.

Should I wait to perform CPR until a trained professional is available?


  • Do not wait until medical professionals arrive. You have a better chance of saving a life if you attempt CPR while waiting for medical help to arrive.
  • When trained medical professionals arrive, tell them what happened. This is an important part of the overall care provided to the person.





  • CPR can save a life by moving blood and oxygen to the brain and lungs.
  • The best way to learn CPR is to take a training class. Look for a class in your community. Almost anyone can learn to do CPR.
  • Do CPR using the C-A-B method. This stands for chest compressions, airway, and breathing.
  • If an AED becomes available at any time, use it immediately. An AED delivers an electric shock to try and restart the heart or return the heartbeat to normal.


This information is not intended to replace advice given to you by your healthcare provider. Make sure you discuss any questions you have with your healthcare provider.



Andersen L.W., Grossestreuer A.V., Donnino M.W.: “Resuscitation time bias”—A unique challenge for observational cardiac arrest research. Resuscitation 2018; 125: pp. 79-82.

Chan P.: Public Health Burden of In-Hospital Cardiac Arrest. Paper commissioned by the Institute of Medicine Committee on Treatment of Cardiac Arrest: Current Status and Future Directions. Available at: http://www.nationalacademies.org/hmd//media/Files/Report%20Files/2015/GWTG.pdf Accessed January 18, 2020

Daya M.R., Schmicker R.H., Zive D.M., et. al.: Out-of-hospital cardiac arrest survival improving over time: results from the Resuscitation Outcomes Consortium (ROC). Resuscitation 2015; 91: pp. 108-115.

Hansen S.M., Hansen C.M., Folke F., et. al.: Bystander defibrillation for out-of-hospital cardiac arrest in public vs residential locations. JAMA Cardiol 2017; 2: pp. 507-514.

Holmberg MJ, Vognsen M, Andersen MS, et. al.: Bystander automated external defibrillator use and clinical outcomes after out-of-hospital cardiac arrest: a systematic review and meta-analysis. Resuscitation 2017; 120: pp. 77-87.

Soar J., et. al.: 2019 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation 2019; 140: pp. e826-e880.

Sun C.L.F., Karlsson L., Torp-Pedersen C., Morrison L.J., Folke F., Chan T.C.Y.: Spatiotemporal AED optimization is generalizable. Resuscitation 2018; 131: pp. 101-107.



To join a Basic Life Support (CPR) course, visit:

Caregiverasia Malaysia- Modified Basic Life Support Workshop

Caregiverasia Malaysia- First Aid Workshop



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Topics: Wellness

Calvin Leong

Written by Calvin Leong

Calvin Leong holds a Master in Medical Education from the University of Dundee, United Kingdom. He is certified in Clinical Wound Care by the ASEAN Wound Care Association. Calvin has 20 years of clinical and lecturing experience focusing on Mentoring in Healthcare, Traumatology and Medical Sciences. Calvin is HRDC certified trainer. He is also a Life Member of The Malaysian Association for the Study of Pain (MASP) and the Malaysian Society of Wound Care Professionals (MSWCP).

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