Should you begin CPR with breaths before chest compressions?

In modern CPR guidelines, particularly for adult victims, the emphasis is on starting with chest compressions rather than rescue breaths. This approach is based on the understanding that maintaining blood circulation is critical to increasing the likelihood of survival. Compressions help circulate oxygen-rich blood to vital organs, including the brain and heart, while also allowing for some passive inhalation of air.

Starting with chest compressions ensures that the most essential function—circulation—is prioritized immediately. The combination of high-quality compressions and minimal interruptions during the sequence of CPR has been shown to improve outcomes significantly. Rescue breaths can be introduced later if the rescuer is trained and if breaths are indicated or necessary, such as in certain situations involving children or when there are specific indications for providing breaths.

The idea of never starting with breaths is reinforced in most adult scenarios, where compressions take precedence.