To start external cardiac compression
1. Place the victim on his/her back, establish an
open airway, and kneel at right angles to the
2. Then locate the victims sternum (breastbone)
a. Baring the chest and locating the sternum by
drawing an imaginary line from one nipple
to the other to identify the proper area of the
sternum, which is darkened in figure 14-2.
b. Locating the lower tip of the sternum with
the index and middle fingers, placing the
heels of your hands above your fingers in the
There is a small piece of cartilage at the
lower end of the sternum (fig. 14-2). A
fracture of this area can damage the liver,
causing hemorrhage (heavy bleeding)
and death. When you place the heels of
your hands on the victims chest, stay
above the tip of the sternum.
3. Place the heel of one hand directly on the
sternum, and the heel of the other on top of the
first. Figure 14-3, view A, shows this technique.
Interlock your fingers, and keep them off the
4. Lean or rock forward with elbows locked, and
apply vertical pressure to depress the sternum
(adult) 1 ½ to 2 inches (fig. 14-3, view B).
5. Then release the pressure, keeping the hands in
6. Administer 60 to 80 compressions per minute.
You wont get as tired if you use the proper
technique, and you will be more effective. Ineffective
compression occurs when the elbows are not locked, the
rescuer is not directly over the sternum, or the hands are
improperly placed on the sternum.
Figure 14-1.Feeling for the carotid pulse.
Figure 14-2.Locating the sternum.
Figure 14-3.Position for cardiac compression.