Knowing the seven steps of CPR can help you understand what to do if somebody collapses, becomes unresponsive and is not breathing normally.

Cardiac arrest is a medical emergency.

When the heart stops effectively pumping blood around the body, the brain and other vital organs are deprived of oxygen. Immediate CPR can help maintain some blood flow until an Automated External Defibrillator, AED, and professional medical help become available.

You do not need to be a healthcare professional to help.

Resuscitation Council UK emphasises that everyone can learn CPR and anyone can use an AED. Bystander CPR and early use of an AED can increase the chance of survival from out-of-hospital cardiac arrest by two to four times. Resuscitation Council UK

The important thing is to recognise the emergency, call 999 and act.

The seven steps of CPR provide a simple way of understanding what to do.

Step 1: Check for Danger

Before approaching the casualty, check that it is safe.

Look for anything that could put you, the casualty or other people at risk.

Hazards could include moving traffic, electricity, fire, smoke, machinery, chemicals, water or falling objects.

Do not put yourself in serious danger.

If the area is safe to approach, move quickly to the casualty.

Step 2: Check for a Response

Check whether the casualty responds to you.

Speak loudly and ask something simple such as:

“Hello, can you hear me?”

Gently shake their shoulders and look for a response.

They may speak, move, open their eyes or otherwise react.

If there is no response, shout for help.

Under the current Resuscitation Council UK adult Basic Life Support guidance, you should suspect cardiac arrest in any person who is unresponsive and call 999 without delay. Resuscitation Council UK

Step 3: Call 999

If the casualty is unresponsive, call 999 immediately and ask for the ambulance service.

This is an important change within the Resuscitation Council UK 2025 adult Basic Life Support guidance.

Previously, many people were taught to establish whether the casualty was breathing normally before making the emergency call.

The current guidance is to initiate the 999 call as soon as you identify that the casualty is unresponsive and assess their breathing while waiting for the call to be answered. Resuscitation Council UK

If you have a mobile phone, put it on loudspeaker.

This allows you to stay beside the casualty while speaking to the ambulance service.

Why the Ambulance Call Handler Will Ask About Breathing

One of the most important things the ambulance service needs to establish is whether an unresponsive casualty is breathing normally.

Expect the call handler to ask questions about the casualty’s response and breathing.

They may ask you to describe exactly what the casualty is doing.

This is important because:

Unresponsive + abnormal breathing = suspected cardiac arrest.

Once cardiac arrest is recognised, the call handler can provide CPR instructions and the emergency response can be managed accordingly.

Resuscitation Council UK describes the role of the ambulance service call handler as critical to the early recognition of cardiac arrest and initiation of CPR. Resuscitation Council UK

Do not simply tell the operator that the casualty is “breathing” because you have seen an occasional gasp.

Describe what you can actually see and hear.

For example:

“He isn’t responding and is only gasping occasionally.”

The call handler can then help you determine whether the breathing is abnormal.

What If You Are Alone and Do Not Have a Phone?

This is an important situation that can easily be overlooked when CPR is taught.

Imagine finding an unresponsive casualty when:

You are completely alone
You do not have a mobile phone
There is no mobile network or satellite connection
Nobody else is nearby

You cannot call 999 while remaining beside the casualty.

Resuscitation Council UK’s current guidance specifically addresses this situation.

Shout loudly for help and continue assessing the casualty’s breathing.

If nobody comes and you believe nobody is going to come, you will have to leave the casualty to summon the ambulance service.

Do this as quickly as possible.

Return to the casualty immediately.

If they remain unresponsive and are not breathing normally when you return, start CPR immediately. Resuscitation Council UK

This can feel counter-intuitive.

We normally teach first aiders not to unnecessarily leave a casualty.

But if you are completely alone with no means of communication, nobody knows that an emergency has happened.

Without somebody summoning the ambulance service, professional medical help will not be on its way.

Should You Leave the Casualty to Find an AED?

This is different.

If you are alone, you should not normally abandon CPR to go searching for a defibrillator some distance away.

If another person is present, send them to retrieve the AED while you remain with the casualty.

Current RCUK guidance says that where no AED is already at the scene and more than one bystander is present, the ambulance service can help direct another bystander towards the nearest AED. Resuscitation Council UK

So there is an important practical distinction:

Leaving briefly because it is the only way to summon an ambulance may be necessary.

Leaving a casualty in cardiac arrest simply to search for an AED is not the same situation.

Step 4: Check for Normal Breathing

Assess whether the casualty is breathing normally.

This distinction is extremely important.

Someone experiencing cardiac arrest may still appear to make occasional breathing movements.

They may:

Gasp
Pant
Take occasional breaths
Make slow or laboured breathing movements
Make unusual breathing noises

These do not necessarily mean the casualty is breathing normally.

Resuscitation Council UK specifically warns that slow, laboured breathing, agonal gasping and panting can occur during cardiac arrest. Resuscitation Council UK

Remember:

Unresponsive + not breathing normally = assume cardiac arrest.

If you are unsure, the ambulance service call handler can help you assess what is happening.

If there is any doubt, Resuscitation Council UK advises assuming cardiac arrest and starting CPR. Resuscitation Council UK

Step 5: Start Chest Compressions

If the casualty is unresponsive and not breathing normally, start CPR.

Kneel beside them.

Place the heel of one hand on the lower half of the breastbone, in the centre of the chest.

Place your other hand on top and interlock your fingers.

Keep your arms straight and position your shoulders vertically above your hands.

Press straight down.

For an adult, compress the chest:

At least 5 cm but no more than 6 cm deep

at a rate of:

100 to 120 compressions per minute.

Allow the chest to return fully after every compression.

Avoid leaning on the casualty’s chest between compressions.

Keep interruptions to chest compressions as short as possible. Resuscitation Council UK

Why Are Chest Compressions Important?

During cardiac arrest, the heart is no longer effectively pumping blood around the body.

Chest compressions manually produce some blood flow.

This can help deliver oxygenated blood to vital organs, particularly the brain and heart, while you wait for defibrillation and professional medical treatment.

Good-quality compressions matter.

Push hard, push fast, allow full recoil and minimise interruptions.

Step 6: Give Rescue Breaths If You Are Trained

If you have been trained and are able to provide rescue breaths, perform:

30 chest compressions followed by 2 rescue breaths.

Open the airway using head tilt and chin lift.

Pinch the soft part of the casualty’s nose closed.

Take a normal breath, make a seal around their mouth and blow steadily until you see the chest start to rise.

Give a second rescue breath and immediately return to chest compressions.

Each breath should provide only enough air to make the chest begin to rise. Avoid excessive ventilation. Resuscitation Council UK

Continue:

30 compressions : 2 rescue breaths

with as few interruptions as possible.

What If You Cannot or Do Not Want to Give Rescue Breaths?

If you are not trained to provide rescue breaths, perform continuous chest compressions.

Do not allow uncertainty about rescue breaths to prevent you from attempting CPR.

The ambulance service call handler can guide you.

RCUK guidance says call handlers should initially provide chest-compression-only instructions unless the caller indicates that they know how to provide rescue breaths, in which case they can facilitate 30:2 CPR. Resuscitation Council UK

Doing something is far better than doing nothing because you are frightened of getting every detail perfect.

Step 7: Use an AED as Soon as Possible

Use an Automated External Defibrillator, AED, as soon as one becomes available.

Anyone can use an AED.

You do not need to be medically qualified and you do not need to decide whether the casualty needs a shock.

The AED analyses the casualty’s heart rhythm and determines whether a shock is appropriate.

Switch it on and follow its spoken or visual instructions.

Expose the casualty’s chest and attach the electrode pads to bare skin in the positions shown on the pads.

If another rescuer is available, CPR should continue while the AED is being prepared and the pads attached wherever possible.

The AED will tell you when it needs to analyse the heart rhythm.

Make sure nobody is touching the casualty during analysis.

If a shock is advised, make sure everybody is clear.

Follow the AED’s instructions to deliver the shock.

Immediately restart CPR afterwards.

If the AED says no shock is advised, immediately restart CPR.

Continue following the AED instructions until professional help takes over or the casualty shows clear signs of life and begins breathing normally. Resuscitation Council UK

The Seven Steps of CPR at a Glance

The seven steps of CPR can therefore be remembered as:

1. Danger
Make sure it is safe to approach.

2. Response
Check for a response and shout for help.

3. Call 999
Call immediately when you identify an unresponsive casualty.

4. Breathing
Assess whether they are breathing normally.

5. Compressions
If they are unresponsive and not breathing normally, start chest compressions.

6. Rescue Breaths
If trained and able, give 30 compressions followed by 2 rescue breaths. Otherwise continue chest compressions.

7. AED
Use a defibrillator as soon as one becomes available and follow its instructions.

Resuscitation Council UK now presents the essential community response even more simply as:

Check → Call → CPR

with an AED used as soon as possible. Resuscitation Council UK

What Does Abnormal Breathing Look Like?

Recognising abnormal breathing is one of the most important parts of identifying cardiac arrest.

People often imagine that somebody experiencing cardiac arrest will be completely still and make no breathing movements whatsoever.

That is not always what happens.

The casualty may gasp or make occasional breathing movements.

These abnormal breaths can cause a bystander to mistakenly believe that the casualty is breathing.

This is one reason the ambulance call handler will ask questions about breathing.

Do not assume that someone is breathing normally simply because you see their chest move occasionally or hear a gasp.

If they are unresponsive and their breathing is abnormal, assume cardiac arrest and start CPR.

What If the Casualty Has a Seizure?

A short period of seizure-like activity can sometimes occur at the beginning of a cardiac arrest.

This can cause confusion because bystanders may assume the casualty has simply experienced a seizure.

Once the seizure-like activity stops, assess their breathing.

If they remain unresponsive and are not breathing normally, assume cardiac arrest and start CPR. Resuscitation Council UK

Can CPR Hurt Someone?

Some people hesitate to perform CPR because they are worried about causing an injury.

CPR is a physical procedure and injuries can occur.

However, Resuscitation Council UK states that the risk of serious harm from performing CPR on somebody who is not actually in cardiac arrest is low. Resuscitation Council UK

If somebody is unresponsive and not breathing normally, do not delay CPR because you are frightened of hurting them.

In a genuine cardiac arrest, failing to act is the far greater danger.

Can Anyone Use a Defibrillator?

Yes.

AEDs are specifically designed so that members of the public can use them.

Once switched on, the AED provides instructions.

It analyses the casualty’s heart rhythm and determines whether defibrillation is appropriate.

You do not need to diagnose the heart rhythm yourself.

Resuscitation Council UK states clearly that anyone can use an AED. Resuscitation Council UK

What If There Are Several People Available?

If other people are present, use them.

One person can call 999.

Another can start CPR.

Someone else can retrieve the AED.

If CPR continues for a prolonged period, rescuers can change over to reduce fatigue while keeping interruptions in chest compressions as short as possible.

Good first aid is not always about one person doing everything.

It is often about using the people and resources around you effectively.

Is CPR Different for Babies and Children?

Yes, and there is a particularly important difference for the lone rescuer without a phone.

Paediatric cardiac arrest is more commonly associated with breathing problems and lack of oxygen, so rescue breaths have greater importance.

Current Resuscitation Council UK paediatric guidance includes five initial rescue breaths before commencing chest compressions when the child is not breathing normally. Resuscitation Council UK

What If You Are Alone With a Child and Have No Phone?

This is different from the adult sequence.

For a single rescuer dealing with a child or infant, if no phone is available, current RCUK guidance says to:

Give 5 initial rescue breaths

then:

Perform CPR for approximately 1 minute

before leaving the child to summon the ambulance service.

Return as quickly as possible and continue CPR. Resuscitation Council UK

This distinction is worth remembering:

Adult + lone rescuer + no phone: summon the ambulance service first, then return and start CPR.

Child or infant + lone rescuer + no phone: give 5 initial rescue breaths and perform CPR for approximately 1 minute before leaving to summon the ambulance service. Resuscitation Council UK

Our Paediatric First Aid training covers these differences practically so learners can practise the appropriate techniques for babies and children.

When Should You Stop CPR?

Once CPR has started, continue until:

Professional medical help takes over
The casualty clearly shows signs of life and begins breathing normally
You become physically unable to continue
The situation becomes unsafe

If another capable person is available, you can swap rescuers when fatigue develops while trying to minimise interruptions to compressions.

Continue following the instructions provided by the ambulance service and AED.

Reading the Seven Steps of CPR Is Not the Same as Practising Them

Understanding the seven steps of CPR is valuable.

But CPR is a practical skill.

Training gives you the opportunity to practise recognising an unresponsive casualty, assessing breathing, performing effective chest compressions, giving rescue breaths and using an AED.

It also allows instructors to introduce the situations that do not always fit perfectly into a diagram.

For example:

What happens if you’re alone?

What if you don’t have a phone?

What if the casualty is gasping?

What if you’re not comfortable giving rescue breaths?

What if the casualty is a child?

What if the trained first aider becomes the casualty?

These are important scenarios because genuine emergencies do not always happen in ideal circumstances.

Practical training allows you to work through them before you ever need to respond for real.