Place the heel of one hand in the center of the chest, right on the breastbone, and put your other hand directly on top. That’s the correct position for hands-only CPR on an adult or teen. The technique is simple by design: just two steps, calling emergency services and pushing hard and fast in the center of the chest.
Exact Hand Placement
The target is the center of the chest, on the lower half of the breastbone (the flat bone running down the middle of the ribcage). Place the heel of one hand there, not your palm or fingers. The heel of your hand is the firm, bony part where your wrist meets your palm. Then place your other hand on top.
You can either interlace your fingers or simply overlap your hands. A randomized trial comparing the two grips found no significant difference in compression quality between them. What matters more is keeping your fingers lifted off the chest so that all your force goes straight down through the heel of your bottom hand into the breastbone. Pressing with splayed fingers spreads force across the ribs instead of concentrating it where it needs to go.
Body Position and Arm Alignment
Hand placement alone won’t produce effective compressions if your body isn’t positioned correctly. Kneel beside the person and place your shoulders directly above your hands. Lock your elbows straight. You want a vertical line from your shoulders through your arms to your hands so you can use your upper body weight, not just arm muscles, to drive each compression.
This matters because effective compressions need to push the chest down at least 2 inches (5 centimeters) but no more than about 2.4 inches (6 centimeters). That takes real force. Bent elbows or off-center shoulders waste energy and produce shallow compressions that don’t circulate blood well enough. Think of it as pressing straight down with your body weight, not muscling through with your arms.
How Fast and How Deep to Push
Compress at a rate of 100 to 120 compressions per minute. That’s roughly two pushes per second. The easiest way to stay on tempo is to think of a song in that beat range. The American Heart Association suggests “Stayin’ Alive” by the Bee Gees, but plenty of familiar songs work: “Uptown Funk” by Bruno Mars, “Jolene” by Dolly Parton, “Eye of the Tiger” by Survivor, “Rolling in the Deep” by Adele, or “Can’t Stop the Feeling” by Justin Timberlake all fall in the 100 to 120 beats per minute range.
Between compressions, let the chest fully recoil. This means lifting enough pressure to let the ribcage spring back to its normal position before you push down again. Full recoil allows the heart to refill with blood between compressions. Leaning on the chest between pushes, even slightly, reduces how much blood gets circulated.
The Full Two-Step Sequence
If you see a teen or adult suddenly collapse:
- Step 1: Call 911 (or your local emergency number). If someone else is nearby, have them make the call while you start compressions immediately.
- Step 2: Push hard and fast in the center of the chest. Keep going with minimal interruptions until emergency medical services arrive or the person starts breathing and moving on their own.
That’s the entire protocol. Hands-only CPR skips rescue breaths entirely. For the first several minutes of a sudden cardiac arrest in an adult, the blood still contains enough oxygen that continuous chest compressions can keep it circulating to the brain and vital organs.
Hands-Only CPR Works as Well as Traditional CPR
A large meta-analysis covering 15 trials found that survival to hospital discharge was 9.3% with chest compressions alone and 10.2% with standard CPR that included rescue breaths. That difference was not statistically significant. Survival with good neurological outcomes was also nearly identical: 5.8% for compressions only versus 6.5% for standard CPR. The takeaway is clear: for adults who collapse from a cardiac event, pushing hard and fast without stopping for breaths is just as effective as traditional CPR performed by bystanders.
This is significant because many people hesitate to perform CPR when they think mouth-to-mouth breathing is required. Hands-only CPR removes that barrier. Any compression is better than none.
Who It’s Designed For
Hands-only CPR is recommended for teens and adults who suddenly collapse. It works best for witnessed cardiac arrests, the kind where someone’s heart suddenly stops and they drop without warning. In these cases, there’s still oxygen in the bloodstream, so continuous compressions keep that oxygenated blood moving.
For infants, children, drowning victims, or people who collapse from a breathing problem (like choking or an asthma attack), conventional CPR with rescue breaths is preferred because oxygen depletion is more likely to be the underlying issue. If you’re untrained in rescue breaths, compressions alone are still better than doing nothing regardless of the situation.
Don’t Worry About Breaking Ribs
One of the biggest fears people have about performing CPR is cracking someone’s ribs. It does happen. Studies report rib fractures in roughly 13% to 26% of CPR cases, with some research finding rates even higher in elderly patients. But rib fractures are considered an ordinary, unavoidable side effect of effective compressions, not a sign you’re doing something wrong. A person in cardiac arrest will die without chest compressions. Broken ribs heal. Keep pushing.
When to Stop Compressions
Continue performing chest compressions until one of three things happens: emergency medical personnel arrive and take over, the person starts showing obvious signs of life (breathing normally, moving, opening their eyes), or you become too physically exhausted to maintain effective compressions. If another bystander is available, take turns every two minutes or so to keep compression quality high. Fatigue sets in faster than most people expect, and shallow, slow compressions don’t circulate blood effectively.