CPR Steps in Australia: The Current DRSABCD Action Plan Explained

CPR Steps in Australia: The Current DRSABCD Action Plan

Cardiopulmonary resuscitation (CPR) is the single most important skill a bystander can perform in a cardiac arrest emergency. In Australia, the standard approach to CPR is guided by the Australian Resuscitation Council (ARC) and follows the DRSABCD action plan. This guide explains each step of the action plan and provides the key technical details that make CPR effective.

Why CPR Matters: The Survival Statistics

Cardiac arrest is one of the leading causes of death in Australia, with approximately 25,000 out-of-hospital cardiac arrests occurring each year. The survival rate for out-of-hospital cardiac arrest in Australia is approximately 10-12%, but this rate can be dramatically improved with prompt bystander CPR and early defibrillation.

For every minute that passes without CPR and defibrillation, the chance of survival decreases by approximately 10%. When bystander CPR is started immediately, survival rates can be two to three times higher than when CPR is not performed. This is why knowing how to perform CPR is so important — in many cases, bystanders are the only people who can make a difference in the critical minutes before emergency services arrive.

The DRSABCD Action Plan

The DRSABCD action plan is the standard framework for responding to an unconscious person in Australia. Each letter represents a step in the sequence:

D — Danger

Before approaching the casualty, assess the scene for any dangers that could put you, bystanders, or the casualty at risk. This includes traffic, electricity, fire, unstable structures, or aggressive individuals. Do not approach if it is unsafe to do so — you cannot help if you become a casualty yourself.

R — Response

Check whether the casualty is responsive by calling out loudly ("Can you hear me?") and gently squeezing their shoulders. Look for any response — eye opening, verbal response, or movement. If there is no response, the casualty is unconscious.

S — Send for Help

Call 000 immediately, or direct a specific bystander to call 000 ("You — call 000 now!"). Do not assume someone else has called. If an automated external defibrillator (AED) is available nearby, direct another bystander to retrieve it. Do not leave the casualty to get the AED yourself if others are available to help.

A — Airway

Open the casualty's airway by tilting the head back and lifting the chin. This moves the tongue away from the back of the throat, which is the most common cause of airway obstruction in an unconscious person. Look inside the mouth for any visible obstruction — if present, remove it carefully.

B — Breathing

Look, listen, and feel for normal breathing for no more than 10 seconds. Look for chest rise and fall, listen for breath sounds, and feel for air movement on your cheek. If the casualty is not breathing normally (or is only gasping, which is not normal breathing), proceed immediately to CPR.

C — CPR (Cardiopulmonary Resuscitation)

Begin CPR immediately if the casualty is not breathing normally. Current ARC guidelines recommend:

• Compression-to-ventilation ratio: 30 compressions to 2 breaths for adults
• Compression rate: 100-120 compressions per minute
• Compression depth: At least 5 cm (but not more than 6 cm) for adults
• Compression position: Centre of the chest, on the lower half of the sternum
• Hand position: Heel of one hand on the chest, other hand on top, fingers interlaced
• Allow full chest recoil: Allow the chest to fully return to its normal position between compressions
• Minimise interruptions: Keep interruptions to compressions to less than 10 seconds

For rescue breaths, tilt the head back, pinch the nose, seal your mouth over the casualty's mouth, and give a breath lasting approximately 1 second. The chest should visibly rise. If you are not trained in rescue breaths or are unwilling to perform them, compression-only CPR (hands-only CPR) is still highly effective and is preferable to no CPR at all.

D — Defibrillation

If an AED is available, use it as soon as possible. Turn on the AED and follow the voice prompts — AEDs are designed to be used by untrained bystanders and will guide you through the process. Continue CPR while the AED is being set up, and resume CPR immediately after any shock is delivered.

CPR for Children and Infants

The DRSABCD action plan applies to all ages, but there are important differences in CPR technique for children and infants:

Children (1 year to puberty):

• Use one or two hands for compressions, depending on the child's size
• Compression depth: approximately one-third of the chest depth
• Give 5 initial rescue breaths before starting compressions
• Compression-to-ventilation ratio: 30:2

Infants (under 1 year):

• Use two fingers for compressions (index and middle finger on the lower half of the sternum)
• Compression depth: approximately one-third of the chest depth
• Give 5 initial rescue breaths before starting compressions
• Cover both the mouth and nose with your mouth for rescue breaths

When to Stop CPR

Continue CPR until:

• The casualty shows signs of life (normal breathing, movement, or response to stimulation)
• Emergency services take over
• An AED advises you to stop for a rhythm analysis
• You are physically unable to continue
• A medical professional directs you to stop

The Importance of Training

Reading about CPR is not the same as being trained to perform it. Hands-on training with a mannequin is essential for developing the muscle memory and confidence needed to perform effective CPR in a real emergency. Ready Set Rescue WA delivers HLTAID009 CPR training onsite at your Perth workplace, with practical mannequin-based training that gives participants genuine competence in CPR and AED use.