How to do CPR when the heart suddenly stops: Press hard, press fast, don’t stop

Ann MacDonald

Contributor, Harvard Health

While I was browsing the produce section of my grocery store the other day, the sound of a panicked voice coming over the store’s loudspeaker made me jump. “Does anyone in the store know CPR? Anyone … CPR … we need you in baked goods!”

I froze. In theory, I know how to perform CPR—cardiopulmonary resuscitation. I took a two-hour course on it nearly 25 years ago. But I hadn’t given it much thought since then and I certainly hadn’t practiced what I learned.

My mind started whirling as I tried to remember the sequence of steps. They’d changed the rules a few years back—I knew that much—so I wouldn’t have to do mouth-to-mouth resuscitation. But where exactly on the chest was I supposed to push? Should I form a fist and push down with my knuckles, or use the ball of my hand?

Suddenly, sirens wailed outside the store. The rescue squad had arrived. Too late, as I learned afterward, for this man, who was a victim of a sudden cardiac arrest. This type of heart attack strikes so fast that there usually aren’t any warning signs. You might see someone grasp his or her chest, collapse, twitch and gasp a few times, and then lie deathly still.

At that point, every minute counts. Enough oxygen remains in the person’s bloodstream to nourish the brain for several minutes—but a bystander has to circulate oxygenated blood to the brain and other organs by pushing down on the chest hard and fast, mimicking the heartbeat.

I’m a health writer. I knew this intellectually. But until those agonizing moments in the grocery store, I never really understood on a gut level just how important every minute is.

The first thing I did when I got home that day was look up an article on CPR published in the Harvard Heart Letter. Here’s the gist of what I learned about doing CPR for a sudden cardiac arrest:Put one hand over the other and press hard in the middle of the chest

  1. Call 911, or have someone else do it.
  2. Place both of your hands, one on top of the other, over the middle of the person’s chest.
  3. Press down hard enough to make the chest move inward about 1.5 to 2 inches.
  4. Relax to let the chest rebound.
  5. Repeat this press-and-relax motion quickly, almost twice a second if you can. (Try keeping time to the old Bee Gee’s song, Stayin’ Alive.)
  6. Don’t stop if the person seems to gasp or move! Keep pushing until help arrives.

Final piece of advice: Be prepared! In an emergency, it’s hard to think straight—something I’ve learned the hard way. So take a refresher course or watch this video on CPR once in a while, so you’ll remember what to do should the need arise. (I’ve even started to practice the CPR “hand-and-arm moves” as part of my daily exercise regimen.)

Today, only about 5% of people survive a sudden cardiac arrest. Bystander CPR more than doubles an individual’s chances of surviving. Wouldn’t you want to “lend a hand” to help someone in cardiac distress? I know I would—and next time I hope to be better prepared.


  1. Anonymous

    I think Pressing of heart should not be so hard that it actually pushes the heart of the body too much. plus, doctor’s attention is also required as soon as possible.

  2. Troy

    Don’t forget to attend a class. There is much more you can learn. A great site listing CPR classes nationwide is

  3. Gracy Singh( )

    Pressing of heart should not be so hard that it actually pushes the heart of the body too much. plus, doctor’s attention is also required as soon as possible.

  4. reema

    awesome info, thank u for sharing.. now my husband is feeling safer that i know what to do 🙂
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  5. April

    I haven’t had to perform cpr on anyone yet but it’s been a long time since I had a course on it. it would be nice if you did up an article for babies too. This is a great reminder and is making me think that maybe I’d better go and take a course again.

  6. CPR New Guidelines

    It’s a very real situation. Heart disease is increasing so the need for CPR is also likely to increase.

    New CPR Guidelines were released Down Under in 2010 – yes we learn CPR in Australia. Hey most of us live near the beach! New guidelines follow DRS ABCD

    D Check for Danger
    R Check for Responsiveness
    S Send for help

    A Open Airway
    B Check for normal Breathing
    C Start CPR – 30 chest impressions: 2 rescue breaths
    D Attach defibrillator (AED) as soon as available and follow prompts

    Lots of resources on YouTube to help.

  7. Bob Trenkamp

    Thanks for the promotional boost. We’re working hard to get half the 12 y/o and older population trained in Bystander CPR.

    If you want a refresher in CPR, AED use, the safe way to perform the Heimlich maneuver, and stroke recognition, there is a 35 minute class video at our website, Saving Lives in Chatham County.

    btw, the ‘1.5″ to 2″ ‘ guideline was changed to ‘2″ or more’ last October 18th.


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  8. Bob Volk

    As someone whose father has had open heart surgery, I appreciate this article. I was not aware that just pumping the heart may be all that is needed to save someone while waiting for paramedics. Thanks!

    • Laura King

      Yes Bob – often that is all that is required and it makes the statistics even more depressing. Seattle and some other cities have significantly increased the number of people who survive a cardiac arrest by rolling out a program of education as well as providing more access to AED devices. The emergency services are fantastic but often they can get caught in traffic or other delays. If more bystanders did CPR, their actions can buy the victim precious time using the techniques Ann outlined above.

      But CPR classes are important as chest compression only CPR doesnt work on all cases. If there has been oxygen deprivation (drowning or infant or very young child) you need to give rescue breaths in addition to chest compressions.

      It only takes about four hours to qualify in CPR and it isn’t difficult to learn yet it could make all the difference.

      Laura King
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  9. Helen Hoart

    Thanks for this post. Great reminder. Coincidentally I’m signed up for a CPR refresher course this Sunday. Now I’ll make sure I attend.

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