If someone collapses, is unresponsive and is not breathing normally, start chest compressions and have someone call 120 and find an AED
The person you help is likely to be family: 79.2% of arrests in the cited Chinese registry occurred at home. With bystander CPR, survival to discharge rose from 3.9% to 16.1% in the pooled research. If the person is unresponsive and is not breathing normally, start compressions in the middle of the chest, 5–6 cm deep at 100–120 per minute. Have a second person call China's 120 and fetch an AED while you continue.
What it takes
Free. A Red Cross or hospital CPR course takes half a day to a day, and the skills remain useful for years. For an unresponsive adult who is not breathing normally, place overlapping hands in the middle of the chest and compress 5–6 cm at 100–120 times per minute.
What you may gain
A meta-analysis of 79 studies and 142,740 people found overall survival to discharge after out-of-hospital cardiac arrest of 7.6%. With bystander CPR, survival rose from 3.9% to 16.1%. Arrest was witnessed in 53%, but only 32% received bystander CPR. China's BASIC-OHCA registry included 38,227 emergency-service cases, of which 30,282 (79.2%) occurred at home. Bystander CPR occurred in 20.3% and survival to discharge was 1.2%. The source recommends starting compressions while a second person calls and retrieves an AED, then following the device's spoken instructions.
Context & considerations
Do not first pinch the area above the upper lip, find relatives or record video. Fear of breaking ribs should not stop firm compressions. Safety clarification: use absent or abnormal breathing together with unresponsiveness to recognize the need for CPR; the original nipple-line placement has been replaced with current middle-of-chest guidance. China's Civil Code Article 184 exempts voluntary emergency rescuers from civil liability for harm caused to the person they rescue.
Research & references
Sasson C et al. (2010). Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes. https://doi.org/10.1161/CIRCOUTCOMES.109.889576; Zheng J et al. (2023). Incidence, process of care, and outcomes of out-of-hospital cardiac arrest in China: a prospective study of the BASIC-OHCA registry. The Lancet Public Health. https://doi.org/10.1016/S2468-2667(23)00173-1; National People's Congress of China (2020). Civil Code, Article 184. https://www.spp.gov.cn/spp/fl/202006/t20200602_463888.shtml; St John Ambulance. How to do CPR on an adult. https://www.sja.org.uk/first-aid-advice/cpr/