When You’re Doing Hands-Only CPR, Staying on Beat Is Lifesaving

But now you have more music options when searching for a guide to perform the lifesaving procedure: the American Heart Association (AHA) recently added several new tunes to its existing list of songs that make good guides for administering life-saving chest compressions when someone experiences a cardiac arrest.

So what are your options beyond the old classic? New additions to the list include songs by Beyoncé (“I’m That Girl,” “Energy”), Taylor Swift (“Enchanted,” “Sparks Fly”), Dua Lipa (“Dance the Night”), and ABBA (“Dancing Queen”), in case any of those are more your speed.

These songs serve as important metronomes when giving someone hands-only CPR, a series of firm and fast chest compressions to get the heart started after it stops, which can make the difference between life and death. According to the Centers for Disease Control and Prevention (CDC), between 60 and 80 percent of the more than 356,000 people who experience cardiac arrest outside a hospital die—but doctors say that performing CPR can double or triple the odds of survival.

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When many people think of CPR, they may only think of mouth-to-mouth resuscitation. "Hands-only CPR is different," says Evan P. Kransdorf, MD, PhD, associate director of heart transplant research and education at the Smidt Heart Institute at Cedars-Sinai. "In conventional CPR, the rescuer briefly pauses chest compressions to provide breaths, but in hands-only CPR there are no breaths provided."

The AHA recommends laypeople—meaning anyone who doesn't work in healthcare—learn hands-only CPR to help save lives. Studies have shown that bystanders are more likely to actually intervene if they don’t have to do mouth-to-mouth resuscitation. And research also shows the hands-only version is just as effective as conventional CPR if done within the first few minutes of a cardiac arrest—we typically have enough oxygen already in the body to last us for a few minutes, but what we need is to keep the blood pumping.

The lifesaving role of hands-only CPR

A cardiac arrest happens when the heart stops pumping completely, and as a result the organs (including the brain) aren’t getting the oxygen and nutrient-rich blood they need to operate, kicking off a life-threatening situation.

"You are acting like an external heart because what you're doing is pushing all that critical, oxygen-filled blood to the vital organs."—Comilla Sasson, MD, PhD

Chest compressions are an attempt to push that blood where it needs to go until emergency services arrive. “You are acting like an external heart because what you're doing is pushing all that critical, oxygen-filled blood to the vital organs so that when the heart is restarted by an automated external defibrillator (AED) or medications, that person’s brain has had enough blood flow so [they] don’t end up with permanent damage,” says Comilla Sasson, MD, PhD, emergency physician at Colorado Permanente Medical Group and vice president for science and innovation for emergency cardiovascular care at the American Heart Association.

Why staying on beat is so important

The window of time in which CPR can help is critical and short—the longer the brain goes without blood and oxygen, the more damage is done, so it's key to start compressions right away. So what role can Taylor Swift, Beyoncé, and Dua Lipa play? Compressions have to be both fast and deep enough to stimulate blood flow, and the songs on AHA's list have all been deemed good guides to stick to for the optimal tempo for CPR: between 100 and 120 beats per minute.

"It's both how quickly the blood is flowing to the rest of the vital organs and also how deep you have to push to get that blood flow," says Dr. Sasson. Compressions that fall between 100 and 120 pushes per minute hit this sweet spot—whether you're doing CPR on an adult, kid, or infant—and humming a song that has the right tempo is one easy way to keep track and make sure you're doing it right.

How to do hands-only CPR

There are only two steps to perform hands-only CPR, according to Dr. Sasson and Dr. Kransdorf:

1. Call 911

2. Push hard and fast on the chest until help arrives

With each push, be sure to press at least two inches into the chest when doing CPR on an adult or child, says Dr. Sasson, and at least 1.5 inches deep for infants.

Ideally, you'll keep going until the person is responsive (“if they push your hands away, that’s a good sign,” says Dr. Sasson). Don't stop until help arrives or you're instructed to, or the person becomes responsive. Keep going until the person can breathe on their own again, says Dr. Sasson; if you are getting too tired to keep on pace and you’re not alone, she suggests swapping out with someone else who can keep the necessary tempo. Take turns if they get tired, too.

Knowing when to administer hands-only CPR

Actually recognizing when cardiac arrest is happening is paramount so it's clear when to do CPR. “We like to say that cardiac arrest is really won or lost in the field,” says Dr. Sasson. “The most important thing is just recognizing that someone's heart has stopped and they've gone into cardiac arrest. Delays in recognition are one of the biggest challenges we have in terms of getting people to do things that we know can save a life in the first 10 to 15 minutes.”

According to the CDC, the symptoms of cardiac arrest include: not breathing, no pulse, suddenly collapsing, and losing consciousness. Before all that happens, someone may feel discomfort in the chest or feel particularly weak, have heart palpitations, or shortness of breath. When all this goes down, it’s time to call 911 and then get pumping.

On the other hand, someone who is having a heart attack doesn’t need CPR but definitely needs to get to a hospital ASAP; heart attacks occur when blood can’t flow through the heart as opposed to the heart stopping completely, says Dr. Sasson. A person having a heart attack can still be awake and talking, but someone having a cardiac arrest will not. “If they’re still responsive, you should not do CPR, but if they suddenly collapse and they’re not responding, breathing, or they’re having very ineffective breaths, that is when you would start,” she says.

4 things to know about hands-only CPR

1. Not doing it perfectly is better than not doing it at all

Of course, having to actually do CPR can be extremely emotional, stressful, and scary—but both Dr. Kransdorf and Dr. Sasson say it’s key that you try, even if you don’t do it perfectly. Trying to get any blood flow to the heart is better than none. Receiving CPR training is one way to ensure you know exactly what to do if the need ever arises; the AHA and American Red Cross have tools to find trainings, plus a wealth of online resources.

2. Cardiac arrests are more common at home

If you're imagining performing CPR on someone, you may envision it happening while you're out and about. But in fact, nine out of 10 cardiac arrests happen at home. This fact underscores the need to learn how to do CPR properly. "The life you're likely to save is going to be someone you love," Dr. Sasson says. For this reason, it might be helpful to keep an AED at home, as well (and to learn how to use it properly).

3. Don’t be afraid to push hard

Some people might be scared to crack or break the sternum or ribs of the person they're trying to save. As upsetting as the idea of hurting someone can be, both Dr. Kransdorf and Dr. Sasson emphasize that it’s important for your chest compressions to be deep and firm enough to actually get air flowing, which requires using your body weight to push. Remember that the person receiving CPR is in bad shape already, and your actions are what can save them. "Ribs can heal, but if someone's heart stops and it never restarts, you have no chance of helping them," says Dr. Sasson.

4. Some people are worried to perform hands-only CPR on women—don't be

As of this year, heart disease is the leading cause of death for women in the United States. Unfortunately, surveys have shown that women are less likely to receive CPR from bystanders than men. Dr. Sasson says this may be because of a fear of hurting someone or being accused of doing something inappropriate. To clarify, CPR should be performed over clothing per the AHA's guidelines, as long as it's not too bulky to interfere with compressions. (Though the chest should be bare when using an AED).

The next time you find yourself rocking to one of these pop songs, consider practicing some CPR moves as well—your jam sesh could prepare you to save a life.