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World desk4 min

AED vs. CPR: What to Do First When Someone Collapses

Call emergency services and start CPR for an unresponsive adult who is not breathing normally or is only gasping. Use an AED as soon as it arrives, following its prompts.
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For an adult who is unresponsive and not breathing normally—or is only gasping—call your local emergency number and start CPR. If someone else is there, have them call and fetch an AED while you keep compressing. If you are alone, activate emergency services first, then begin CPR immediately. Turn on the AED as soon as it arrives and follow its prompts. CPR and an AED are not alternatives: CPR buys time while the AED checks whether a shock is needed.

What to do first when someone has cardiac arrest

  1. Check that the scene is safe. Tap the person and shout to see whether they respond.
  2. Check breathing. If the adult is unresponsive and not breathing normally or is only gasping, treat it as a suspected cardiac arrest. A lay rescuer should not delay to check for a pulse.
  3. Call emergency services. Use your local emergency number. If others are present, direct one person to call and another to get an AED. If alone, call first, then start CPR; use speakerphone if available so you can follow dispatcher instructions.
  4. Start chest compressions. Push hard and fast in the center of the chest at 100–120 compressions per minute, to a depth of at least 2 inches (5 cm), while avoiding excessive depth. Let the chest return fully between compressions. A bystander responding to a sudden adult collapse can use hands-only CPR; follow dispatcher instructions where available. American Heart Association CPR guidance
  5. Keep going while the AED is fetched. Do not stop compressions just because someone is going to retrieve the device.

Continue until the person shows signs of life, emergency professionals take over, or the AED directs a brief pause for analysis or treatment.

Should you use an AED or do CPR first?

Start CPR as soon as you have called for help; use the AED as soon as it is available. Compressions help circulate blood while help and the device are coming. The AED analyzes the heart rhythm and can deliver a shock if its analysis indicates one. It does not replace CPR, and you do not need to decide whether the rhythm is shockable. The American Heart Association’s 2025 adult basic life support guidance and the 2025 Resuscitation Council UK adult guidance support a response that combines early CPR with prompt AED use.

If you are alone

Activate emergency response first, then immediately begin compressions. Do not leave the person to search for an AED if doing so would delay calling for help or leave them without CPR; follow the emergency dispatcher’s instructions.

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If other people are present

Give specific instructions: ask one person to call emergency services and another to find an AED, while you continue CPR. If more trained or willing responders are available, they can take turns compressing to limit fatigue, with the change made quickly.

How to use an AED when it arrives

An automated external defibrillator (AED) is designed to analyze a person’s heart rhythm and advise whether a shock is needed. Follow the voice and visual prompts rather than trying to interpret the rhythm yourself.

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  2. Expose the chest. Remove or cut away clothing over the chest. If the chest is wet, dry it where the pads will go.
  3. Apply the pads to bare skin. Place them according to the diagrams on the pads or device. Follow the prompts if anything about placement is unclear.
  4. Pause only when directed. Make sure nobody is touching the person during rhythm analysis. If the AED advises a shock, make sure everyone is clear before pressing the shock button or allowing the unit to deliver it automatically.
  5. Resume CPR promptly. After a shock—or if no shock is advised—follow the AED’s instruction to resume compressions. Keep following its prompts until help takes over or the person shows signs of life.

An AED may advise no shock; that does not mean the emergency is over. As Dr. Mary Ann Peberdy, professor of medicine and emergency medicine at Virginia Commonwealth University, explains in the American Heart Association’s September 8, 2026 explainer, “If no shock is advised, it will tell you to resume CPR.”

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Cardiac arrest is not the same as a heart attack

A heart attack is a problem with blood flow to the heart. Cardiac arrest occurs when the heart stops pumping effectively. A heart attack can lead to cardiac arrest, but the terms describe different conditions. The CPR-and-AED steps here are for suspected cardiac arrest: an adult who is unresponsive and not breathing normally or is only gasping. See the American Heart Association’s comparison of cardiac arrest and heart attack.

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Why bystander action matters

The American Heart Association reported in its September 8, 2026 explainer that more than 350,000 adults in the United States experience out-of-hospital cardiac arrest each year, bystanders administer CPR in about 40% of cases, and about 1 in 8 people who have cardiac arrest in a public setting receive a shock from a bystander using an AED. These are AHA-reported figures; the 1-in-8 statistic refers specifically to public settings. American Heart Association

You do not need certification to use an AED. CPR and AED training can help you respond more confidently, but do not wait for training or a trained person before calling for help and starting compressions.

This sequence is for a general adult bystander response. Emergency numbers and advice for children, infants, drowning, pregnancy, trauma, and other special circumstances can differ; use current local guidance for those situations.

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