What Is The 30-2 Rule When Giving CPR?

Even if you're someone who has undergone formal training in cardiopulmonary resuscitation (CPR), that knowledge can sometimes go out the window in the face of a real-life emergency. Whether you're certified in CPR or not, it's important to know the signs indicating a person may be in need of this life-saving intervention.

The number-one sign that a person is in need of CPR is if they are not breathing. According to ProCPR, brain damage can set in after a mere four to six minutes of oxygen deprivation. Therefore, time is of the essence. However, a person doesn't need to be completely oxygen deprived for CPR to be required. A person taking sporadic gasps of breath is also a sign that CPR should be administered. The same is true if a person is not breathing while simultaneously unconscious, or if a pulse cannot be detected. Some scenarios in which CPR may be required include near drowning incidents, sudden cardiac arrest or collapse, automobile accidents, or electric shock.

Even if you're not 100% sure a person is in need of CPR, it's best to err on the side of caution. Not performing CPR can have more serious consequences than performing unnecessary CPR. As you prepare to intervene, remember to keep the 30-2 rule in mind.

30 chest compressions and 2 breaths

After you have called for emergency services and deemed the situation safe in order to approach the individual, the American Heart Association (AHA) advises taking no more than 10 seconds to check for signs of breathing or a pulse (via UCDavisHealth). As you proceed, follow the 30-2 rule, which refers to 30 chest compressions followed by two breaths.

To do so, first ensure the person is positioned flat on their back and remove any clothing that may hinder CPR, if possible. With one hand, place the heel of your palm on the bottom half of the breastbone, while placing the heel of your opposite hand over your initial hand. Compress downward approximately 2 inches and maintain a rhythm of 100 to 120 compressions every 60 seconds. After every 30 compressions, tilt the individual's head back, lift the chin, and administer two breaths for a duration of 1 second each. Continue this cycle until emergency personnel are on the scene or the person becomes responsive. Note that if two people are able to administer CPR, they should switch out every 2 minutes.

When to change the 30-2 rule to the 15-2 rule

While these instructions remain predominantly the same for administering CPR to children, there are some differences. For example, a person may use either one or two hands to issue compressions (via UCDavisHealth). Alternatively, if the child has a pulse below 60 per minute, engage in rescue breathing by administering a 1-second breath every two to three seconds, totaling approximately 20 to 30 breaths every 60 seconds. The final difference to be aware of is that if two people are giving CPR to a child, the 30-2 rule changes to the 15-2 rule, which refers to 15 chest compressions followed by two breaths. The same is true if two people are administering CPR to an infant. Each person will want to use the thumb-encircling technique to administer compressions approximately 1.5 inches in depth. For single rescuers, the 30-2 rule still applies to both children and infants. The sole rescuer may use the two thumb-encircling technique, two fingers, or the heel of only one hand to administer infant compressions.

While CPR can be life-saving, there are situations in which it is not advised. For example, do not approach if the situation is potentially dangerous and a threat to your safety. According to ProCPR, once a person resumes breathing, regains consciousness, or emergency services have arrived, you can cease administering CPR or let another person take over if you feel yourself getting weak or tired.