CPR chest compressions go on the lower half of the breastbone (sternum), roughly in the center of the chest. The exact spot and technique change depending on whether the person is an adult, a child, or an infant, but the general target is always the middle of the chest, never the stomach or the very bottom tip of the breastbone.
Hand Placement for Adults
Place the heel of one hand on the center of the chest, on the lower half of the breastbone. Then place your other hand directly on top of the first, interlocking your fingers. Your hands should sit just below the nipple line. Push straight down at least 2 inches deep, at a rate of 100 to 120 compressions per minute.
An important caution: the nipple line used to be taught as a reliable landmark, but research has shown it’s not as accurate as once believed. A study in the journal Resuscitation found that using the line between the nipples as a guide placed rescuers’ hands over the xiphoid process (the small, flexible tip at the very bottom of the breastbone) in nearly half of patients tested. This was especially common when a male rescuer performed CPR on an older or shorter female patient. Pressing on the xiphoid or the soft area below it can injure internal organs rather than compress the heart. Current guidelines recommend aiming for the middle of the lower half of the breastbone rather than relying on the nipple line alone.
To find the right spot, visualize the breastbone running vertically down the center of the chest. You want the heel of your hand on the lower half of that bone, but not so low that you’re on the soft tip or the stomach area beneath it. If you feel the bone end and give way to soft tissue, move your hand slightly higher.
Hand Placement for Children and Infants
For children (roughly age 1 through puberty), compressions go in the same location: the center of the chest, on the lower half of the breastbone. The difference is force. You can use one or two hands depending on the child’s size, pushing to a depth of about 2 inches. A smaller child may only need one hand to reach that depth comfortably.
For infants under 1 year old, use two fingers instead of your palm. Place your index and middle fingers on the center of the chest, just below the nipple line. Push down about 1.5 inches. Infant ribs are flexible and the chest is small, so two fingers provide enough force without risking injury. The compression spot is the same general area as for adults, just scaled down.
CPR During Pregnancy
Hand placement for a pregnant person stays the same: center of the chest, lower half of the breastbone, at least 2 inches deep. The key difference is what happens below. Avoid pressing on the abdomen or lower body entirely. If a second rescuer is available, they should gently push the uterus to the patient’s left side. In late pregnancy, the weight of the uterus can compress major blood vessels and reduce how much blood the heart can pump, making compressions less effective. Shifting it leftward helps restore blood flow.
Where the Person Should Be Lying
The person receiving CPR should be flat on their back on the firmest surface available. For years, guidelines emphasized moving someone off a bed and onto the floor before starting compressions. The logic was sound: on a soft mattress, up to 57% of your compression force can be absorbed by the surface instead of reaching the chest.
However, recent evidence has complicated this advice. A 2024 systematic review found that compression depth on the floor versus a firm mattress differed by only about 2 to 5 millimeters, a gap that wasn’t statistically significant. More importantly, roughly a quarter of bystanders in out-of-hospital cardiac arrests face barriers to moving the person to the floor, whether due to the person’s size, furniture, or physical limitations. These barriers delay the start of CPR and sometimes prevent bystanders from attempting it at all.
The practical takeaway: if you can quickly and safely get the person onto the floor or another hard surface, do it. If moving them would delay compressions by more than a few seconds, start CPR where they are. On a hospital bed, activating the bed’s CPR mode (which firms the mattress) or sliding a backboard under the patient are standard workarounds, but these matter less for bystanders at home. Starting fast matters more than finding the perfect surface.
Your Body Position Matters Too
The 2025 American Heart Association guidelines emphasize that the patient’s torso should be at approximately the level of your knees. This lets you lock your arms straight, stack your shoulders directly over your hands, and use your upper body weight rather than arm strength alone. If the person is on a bed and you can’t lower it, kneeling on the bed beside them can help you get the right angle. Compressions from a standing position at bedside tend to be too shallow because you can’t generate enough downward force.
Where AED Pads Go
If an automated external defibrillator is available, its pads go in different spots than your hands. One pad is placed on the upper right chest, below the collarbone. The second goes on the lower left side of the chest, under the armpit. This positioning puts the heart between the two pads so the electrical shock travels through it effectively. On women, place pads to avoid breast tissue, repositioning as needed. An alternative is one pad on the front of the chest and one on the back, which works equally well.
You’ll alternate between compressions and defibrillation as the AED instructs. Remove your hands from the chest before the AED delivers a shock, then resume compressions immediately after. The hand placement for compressions stays the same throughout.