CPR in Pakistan: How to Perform Basic Life Support While Waiting for Ambulance
📋 Table of Contents
- What Is CPR and Why It Matters
- When to Start CPR (Recognizing Cardiac Arrest)
- Hands-Only CPR – Step by Step
- Compression Rate, Depth & Technique
- How to Use an AED
- CPR for Children & Infants
- Common CPR Mistakes to Avoid
- After CPR – What to Do When Ambulance Arrives
- FAQs – CPR in Pakistan
- Related Articles & Services
Every year, thousands of Pakistanis die from sudden cardiac arrest — often because no one nearby knew how to perform CPR. In many of these cases, the person could have survived if a family member, colleague, or bystander had started chest compressions immediately while waiting for an ambulance.
CPR is not complicated. You don't need to be a doctor or a paramedic. You don't even need to give mouth-to-mouth breaths (hands-only CPR is now recommended for untrained bystanders). What you need is the courage to act and the knowledge to do it correctly.
This guide is written for Pakistani families in simple, clear language. It covers when to start CPR, exactly how to do it, how to use an AED if available, and how to coordinate with the ambulance service. By the end, you'll have the knowledge to potentially save a life.
❤️ What Is CPR and Why It Matters
CPR (Cardiopulmonary Resuscitation) is an emergency procedure that manually pumps blood to the brain and vital organs when a person's heart has stopped beating. Without CPR, brain damage begins within 3–4 minutes, and death can occur within 8–10 minutes.
What happens during cardiac arrest:
- 💔 The heart stops pumping blood effectively
- 🧠 The brain is deprived of oxygen
- ⏱️ Brain cells begin dying within 3–4 minutes
- 🏥 An ambulance may take 10–30 minutes to arrive in Pakistan
- ❤️ CPR bridges the gap — keeping blood flowing until help arrives
💡 CPR Survival Statistics
Without CPR: Survival rate from out-of-hospital cardiac arrest is less than 5%.
With immediate CPR: Survival rate can increase to 20–30% — and up to 50% if an AED is used quickly.
Every minute without CPR: Survival chances drop by approximately 10%.
🚨 When to Start CPR (Recognizing Cardiac Arrest)
Before starting CPR, you must confirm the person is actually in cardiac arrest. Here's how to check.
Step 2 – Check breathing: Look at the chest for 5–10 seconds. Is it rising and falling normally?
Step 3 – Check pulse (if trained): Feel for a pulse at the neck (carotid artery) for 5–10 seconds.
Step 4 – Decide: If the person is unresponsive AND not breathing normally (or only gasping), START CPR IMMEDIATELY.
| Sign | What It Means | Action |
|---|---|---|
| Unresponsive + Not breathing | Cardiac arrest | 🔴 Start CPR immediately + call ambulance |
| Unresponsive + Gasping/agonal breathing | Cardiac arrest (common) | 🔴 Start CPR immediately + call ambulance |
| Unresponsive + Normal breathing | Unconscious but heart working | 🟡 Recovery position, monitor breathing, call ambulance |
| Responsive + Breathing | Not cardiac arrest | 🟢 Keep calm, assess for other injuries, call ambulance if needed |
| Seizure activity | Could be cardiac arrest or seizure | 🟡 Wait for seizure to stop, then check breathing. Start CPR if not breathing. |
🙌 Hands-Only CPR – Step by Step
For untrained bystanders, hands-only CPR is now recommended. It's simple, effective, and doesn't require mouth-to-mouth breathing. Here's exactly how to do it.
🙌 Hands-Only CPR – 6 Simple Steps
Step 1 – Call for help: Shout for someone to call an ambulance (1122 or +92 329 8041122). If alone, call on speakerphone.
Step 2 – Position the person: Lay them flat on their back on a firm surface.
Step 3 – Place your hands: Put the heel of one hand on the center of the chest (lower half of the breastbone). Place your other hand on top, fingers interlocked.
Step 4 – Position your body: Kneel beside the person. Keep your arms straight, shoulders directly above your hands.
Step 5 – Push hard and fast: Press down at least 5–6 cm (2–2.4 inches). Push at a rate of 100–120 compressions per minute.
Step 6 – Don't stop: Continue compressions until the ambulance arrives, an AED is available, or the person starts breathing.
Compression Rate – What 100–120 Per Minute Feels Like
To maintain the correct rate, push to the beat of a song. Popular choices in Pakistan:
- 🎵 "Stayin' Alive" by Bee Gees — the classic CPR song
- 🎵 "Dil Dil Pakistan" — patriotic and rhythmic
- 🎵 "Jazba-e-Junoon" — high-energy beat
- 🎵 Counting out loud: "One and two and three and four..."
📏 Compression Rate, Depth & Technique
Getting the technique right makes CPR effective. Here are the key parameters.
| Parameter | Adult | Child (1–12 years) | Infant (under 1 year) |
|---|---|---|---|
| Compression Rate | 100–120/min | 100–120/min | 100–120/min |
| Compression Depth | 5–6 cm | ~5 cm (1/3 chest depth) | ~4 cm (1/3 chest depth) |
| Hand Position | Two hands, center of chest | One or two hands, center of chest | Two fingers, just below nipple line |
| Compression:Breath Ratio | 30:2 (if trained) | 30:2 (if trained) | 30:2 (if trained) |
| Hands-Only OK? | ✅ Yes | ✅ Yes (if untrained) | ⚠️ Prefer 30:2 if trained |
Technique Tips for Effective Compressions
- 💪 Push hard: Don't be afraid of breaking ribs — effective CPR often causes rib fractures, but saving the heart and brain is the priority.
- ⚡ Push fast: 100–120 per minute is faster than most people think.
- 🔄 Full recoil: Let the chest come back up completely between compressions.
- 🚫 Minimize interruptions: Try not to stop for more than 10 seconds.
- 🔄 Switch rescuers: If someone else is available, swap every 2 minutes to avoid fatigue.
- 🛏️ Firm surface: Move the person to the floor if they're on a soft bed.
- 👕 Remove clothing: If possible, remove thick clothing from the chest.
- 📍 Correct hand position: Center of chest, not on the stomach or ribs.
📊 CPR Effectiveness vs Compression Quality
*Even imperfect CPR is better than no CPR. Do your best.
⚡ How to Use an AED (Automated External Defibrillator)
An AED is a portable device that delivers an electric shock to restart the heart. If one is available, it dramatically improves survival chances. Modern AEDs are designed for anyone to use — they give voice instructions.
Step 2 – Attach pads: Bare the chest. Attach one pad to the upper right chest, the other to the lower left side (below the armpit).
Step 3 – Plug in connector: If required, plug the pad cable into the AED.
Step 4 – Stand clear: Ensure no one is touching the person. The AED will analyze the heart rhythm.
Step 5 – Deliver shock: If the AED says "shock advised," press the shock button. Ensure everyone is clear.
Step 6 – Resume CPR: Immediately continue chest compressions after the shock.
Step 7 – Follow AED prompts: The AED will re-analyze every 2 minutes and prompt you as needed.
• Do not use an AED on a wet chest — dry it first.
• Do not use on a person with a pacemaker directly over the device (you'll see a lump under the skin).
• Do not touch the person during shock delivery.
• Remove medication patches from the chest before attaching pads.
• AEDs are safe for children — use pediatric pads if available, otherwise adult pads.
AEDs in Pakistan: AEDs are becoming more common in airports, shopping malls, and some offices in major cities. However, public access AEDs are still rare. If you work in a large organization, consider advocating for an AED on-site.
👶 CPR for Children & Infants
Pediatric CPR differs from adult CPR in compression depth and technique. Cardiac arrest in children is often caused by respiratory problems, so rescue breaths are more important.
Child CPR (1–12 years)
- 👐 Hands: One or two hands in the center of the chest
- 📏 Depth: About 5 cm (one-third of chest depth)
- 🔄 Ratio: 30 compressions : 2 breaths (if trained)
- 💨 Breaths: Gentle breaths — just enough to see the chest rise
- ⚡ AED: Use pediatric pads if available; adult pads if not
Infant CPR (under 1 year)
- 👆 Hands: Two fingers in the center of the chest, just below the nipple line
- 📏 Depth: About 4 cm (one-third of chest depth)
- 🔄 Ratio: 30 compressions : 2 breaths (if trained)
- 💨 Breaths: Very gentle puffs — cover the baby's mouth and nose with your mouth
- 👶 Head position: Keep head in neutral position (not tilted too far back)
- ⚡ AED: Use pediatric pads with attenuator if available
❌ Common CPR Mistakes to Avoid
These mistakes reduce CPR effectiveness. Learn them so you don't make them in an emergency.
- ❌ Not starting CPR at all: Fear of doing harm keeps people from acting. Remember: if the person is in cardiac arrest, they are clinically dead — you cannot make it worse.
- ❌ Delaying to check for a pulse: Pulse checks are unreliable and waste time. If unresponsive and not breathing normally, start CPR.
- ❌ Compressing too slowly: The rate should be 100–120 per minute — faster than most people think.
- ❌ Compressing too shallow: Push at least 5–6 cm in adults. Shallow compressions don't circulate blood.
- ❌ Not allowing full recoil: Let the chest come back up completely between compressions.
- ❌ Interrupting too often: Try not to stop for more than 10 seconds.
- ❌ Wrong hand position: Center of the chest, not on the stomach or ribs.
- ❌ Giving up too soon: Continue until the ambulance arrives or the person shows signs of life.
- ❌ Forgetting to call the ambulance: Put your phone on speaker and call +92 329 8041122 while starting CPR.
- ❌ Being afraid of breaking ribs: Rib fractures are common but survivable. Brain death is not.
🚑 After CPR – What to Do When Ambulance Arrives
Your job doesn't end when the ambulance arrives. Here's how to hand over effectively.
Step 2: Give a clear handover: "The patient collapsed at [time]. I started CPR at [time]. No response so far."
Step 3: Tell them if an AED was used and how many shocks were delivered.
Step 4: Mention any known medical conditions, medications, or allergies.
Step 5: Provide the patient's name, age, and your relationship.
Step 6: Step back and let the paramedics work. Be ready to answer questions.
Step 7: If you're family, prepare to follow the ambulance to the hospital.
What the paramedics will do:
- 📈 Attach a cardiac monitor and assess rhythm
- ⚡ Defibrillate if indicated
- 💊 Administer emergency medications (epinephrine, amiodarone)
- 🫁 Manage the airway with oxygen and possibly intubation
- 💉 Establish IV access for medications
- 🏥 Continue CPR and transport to the nearest appropriate hospital
For critical patients, our ICU ambulances are equipped with ventilators, defibrillators, and cardiac monitors to continue advanced care en route.
❓ Frequently Asked Questions – CPR in Pakistan
1. Can I perform CPR if I have no medical training?
Yes. Hands-only CPR (chest compressions only, without mouth-to-mouth) is specifically recommended for untrained bystanders. Push hard and fast in the center of the chest at 100–120 compressions per minute. Even imperfect CPR is far better than no CPR.
2. How hard should I push during CPR?
Push at least 5–6 cm (2–2.4 inches) deep in adults — about one-third of the chest depth. You may hear or feel ribs crack. Do not stop — rib fractures are survivable, but brain death from lack of blood flow is not.
3. Do I need to give mouth-to-mouth breaths?
For untrained bystanders, hands-only CPR (compressions only) is recommended. If you are trained and willing, give 30 compressions followed by 2 rescue breaths. For children and drowning victims, rescue breaths are more important — but compressions are still the priority.
4. What if I'm alone and need to call an ambulance while doing CPR?
Put your phone on speaker mode, call +92 329 8041122 or 1122, and place the phone nearby so the dispatcher can hear you. Start CPR immediately while giving location details. Do not leave the person to make a call unless absolutely necessary.
5. How long should I continue CPR?
Continue CPR until: (1) the ambulance arrives and paramedics take over, (2) an AED is available and instructs you to stop, (3) the person shows signs of life (breathing, movement, consciousness), or (4) you are physically unable to continue. Do not stop because you think it's "too late."
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