Someone collapses in front of you. They are not responding and not breathing normally. You have minutes to act before brain damage becomes irreversible. Knowing the correct sequence of basic life support can mean the difference between life and death, yet many healthcare professionals struggle to recall the exact steps under pressure.
The DRSABCD action plan provides a clear framework for adult basic life support. Combined with the 30:2 CPR technique (30 chest compressions followed by 2 rescue breaths), this approach aligns with Australian Resuscitation Council guidelines and gives you a systematic method to respond to cardiac arrest. You need to assess danger, check responsiveness, activate emergency services, manage the airway, verify breathing, deliver effective compressions, and apply an AED as soon as possible.
This guide walks you through each step of adult BLS in the order you should perform them. You will learn how to apply DRSABCD correctly, execute high-quality CPR at the proper 30:2 ratio, and use an automated external defibrillator safely. Whether you are refreshing your skills or learning the sequence for the first time, these steps will help you respond confidently when someone experiences cardiac arrest.
What adult BLS and DRSABCD involve
Adult basic life support is a systematic approach to maintaining circulation and breathing in someone experiencing cardiac arrest. You follow a specific sequence that prioritises chest compressions and early defibrillation to give the person the best chance of survival. The DRSABCD action plan structures these basic life support steps for adults into a memorisable framework that ensures you do not miss critical actions when responding to an emergency.
DRSABCD guides you through seven distinct stages, from assessing the scene to applying an automated external defibrillator. Each letter represents an action you must complete before moving to the next step. Australian Resuscitation Council guidelines recommend this sequence because it addresses the most common causes of preventable death in cardiac arrest situations. You check for dangers first to protect yourself, then verify responsiveness, activate emergency services, manage the airway, assess breathing, start CPR if needed, and finally attach an AED.
The DRSABCD sequence explained
Each letter in DRSABCD tells you what to do at that stage of the emergency response. You move through the sequence in order, completing each action before progressing to the next:
- D (Danger): Check the scene for hazards that could harm you, the patient, or bystanders
- R (Responsive): Assess whether the person responds to verbal commands or physical stimulation
- S (Send for help): Call 000 and ask someone to retrieve an AED
- A (Airway): Open the person’s airway using the head tilt/chin lift technique
- B (Breathing): Check if the person is breathing normally for no more than 10 seconds
- C (CPR): Begin chest compressions and rescue breaths if breathing is absent or abnormal
- D (Defibrillation): Attach the AED as soon as it arrives and follow the voice prompts
Following DRSABCD in sequence prevents you from exposing yourself to danger or wasting time on actions that will not help the person survive.
Why the 30:2 ratio matters
The 30:2 compression-to-breath ratio maximises blood flow to vital organs while still providing oxygen. You deliver 30 chest compressions at a rate of 100 to 120 per minute, then give 2 rescue breaths that each last about one second. This cycle repeats continuously until the person shows signs of recovery, advanced help arrives, or you become too exhausted to continue.
Research shows that chest compressions are the most critical component of CPR. The 30:2 ratio keeps interruptions to compressions brief while still oxygenating the blood. You push down at least 5 centimetres on the adult chest and allow full recoil between compressions to let the heart refill with blood.
Step 1. Use DRS to make the scene safe
The first three letters of DRSABCD form the foundation of your emergency response. You must complete Danger, Responsive, and Send for help before attempting any medical intervention. These basic life support steps for adults protect you from harm and ensure professional help is on the way before you commit to hands-on care. Skipping these steps puts you at risk and may delay the definitive treatment the person needs.
Check for dangers before approaching
You scan the scene for hazards that could injure you, the patient, or anyone nearby. Look for obvious threats such as traffic, fire, electrical hazards, unstable structures, aggressive bystanders, or chemical spills. Your safety comes first because you cannot help anyone if you become a second casualty.
Move the person only if danger is immediate and cannot be eliminated. For example, you would drag someone away from a car that is leaking fuel, but you would not move someone who has collapsed in a safe indoor location. Moving a patient unnecessarily can worsen spinal injuries or other trauma.
Removing yourself from danger is not cowardice; it is the first rule of effective emergency response.
Assess responsiveness with talk and touch
You check if the person responds to your voice and physical stimulation. Speak loudly and clearly by asking "Can you hear me?" or "Open your eyes." If you get no response, squeeze their shoulders firmly while repeating your verbal commands. This combination of sound and touch is called the talk-and-touch method.
A person who does not respond or only groans without opening their eyes is unconscious and needs immediate help. Any response, even a weak one, means they have some level of consciousness and you move to assessing their specific injuries rather than assuming cardiac arrest.
Send for help immediately
You call 000 as soon as you confirm the person is unresponsive. State your location clearly and describe the person’s condition: "Someone has collapsed and is not responding." The operator will send an ambulance and guide you through the next steps if needed.
Delegate someone to retrieve an AED if other people are present. Point to a specific person and say "You in the blue shirt, get the defibrillator from reception and bring it here." Do not leave the patient alone to fetch equipment yourself unless absolutely necessary.
Step 2. Open airway and check breathing
You move to airway management once you have confirmed the person is unresponsive and help is on the way. The A and B steps of DRSABCD work together because you cannot accurately assess breathing until you have opened the airway. An unconscious person’s tongue can fall backward and block their throat, preventing air from reaching their lungs even if their respiratory muscles are still trying to work. These basic life support steps for adults require you to reposition the head before you attempt to determine whether the person needs CPR.
Position the person and open the airway
You use the head tilt/chin lift technique to open the airway. Place one hand on the person’s forehead and apply gentle but firm pressure to tilt their head backward. Put your other hand under the point of their chin and lift upward, pulling the jaw away from the chest. This movement brings the tongue forward and creates a clear passage from the mouth to the lungs.
Keep the person on their back on a firm, flat surface such as the floor. You need a solid surface beneath them to perform effective chest compressions if CPR becomes necessary. The head tilt should be moderate, not extreme, and the chin lift should open the mouth slightly without closing it completely.
Look, listen, and feel for breathing
You spend no more than 10 seconds checking for normal breathing. Position your face close to the person’s mouth and nose while maintaining the head tilt/chin lift. Watch their chest and upper abdomen for rising and falling movement. Listen for the sound of air moving in and out. Feel for breath against your cheek.
Normal breathing has a regular rhythm and adequate depth. You should see clear chest movement, hear quiet air flow, and feel consistent breath against your skin. If you detect all three signs and they appear normal, the person does not need CPR.
Ten seconds is enough time to identify normal breathing; spending longer delays potentially life-saving compressions.
Recognize abnormal breathing patterns
Agonal gasps are not normal breathing and require immediate CPR. These gasps are irregular, infrequent, and noisy. The person might make snorting or gurgling sounds, or their mouth might open and close without producing effective air movement. You may also see the chest heave occasionally without establishing a regular breathing pattern.
Treat any abnormal breathing as absent breathing and begin CPR immediately. Other signs that indicate you should start compressions include no chest movement, no sounds of breathing, no air felt against your cheek, or any doubt about whether breathing is adequate. If you are uncertain, starting CPR is safer than watching and waiting.
Step 3. Perform adult CPR at 30:2
You begin CPR immediately if the person is unresponsive and not breathing normally. The 30:2 ratio means you deliver 30 chest compressions followed by 2 rescue breaths, then repeat this cycle without stopping until help arrives or the person recovers. Chest compressions are the most critical component of these basic life support steps for adults because they manually pump blood to the brain and heart. You must start compressions within seconds of confirming absent or abnormal breathing to maximise the person’s chance of survival.
Position your hands and deliver compressions
You kneel beside the person’s chest and place the heel of one hand on the centre of their lower sternum. Put your other hand on top of the first hand and interlock your fingers. Position yourself directly above the person’s chest with your shoulders aligned over your hands and your arms locked straight. This positioning lets you use your body weight to achieve adequate compression depth.
Push straight down at least 5 centimetres into the chest, then release completely to allow the chest to recoil fully. You compress at a rate of 100 to 120 compressions per minute, which equals about 2 compressions per second. Count aloud to maintain your rhythm: "One, two, three, four…" up to thirty. Full chest recoil between compressions is essential because it allows blood to flow back into the heart chambers.
Effective compressions require you to press hard and fast without interruption, not gently or slowly.
Deliver two rescue breaths after 30 compressions
You pause compressions briefly after the thirtieth push to give 2 rescue breaths. Maintain the head tilt and chin lift with one hand on the forehead and the other under the chin. Pinch the person’s nose closed with your thumb and index finger. Take a normal breath, seal your mouth completely over the person’s mouth, and blow steadily for about 1 second. You should see the chest rise as air enters the lungs.
Watch the chest fall as air escapes, then give the second breath using the same technique. Each breath should last 1 second and produce visible chest rise. If the first breath does not make the chest rise, reposition the head to ensure the airway is open, check that your mouth seal is complete and the nose is pinched, then try again. Avoid blowing too hard or too long, as this can force air into the stomach instead of the lungs.
Continue the cycle until help arrives
You return to chest compressions immediately after the second breath without checking for breathing or a pulse. Repeat the 30:2 cycle continuously until the person starts breathing normally and moving, an AED arrives and is ready to use, paramedics take over, or you become too exhausted to continue. Minimising interruptions to compressions is critical because blood flow stops each time you pause.
Switch rescuers every 2 minutes if another person trained in CPR is available. Fatigue reduces compression quality, so rotating rescuers maintains effective depth and rate. The changeover should take less than 5 seconds to avoid prolonged interruption to blood flow.
Step 4. Attach an AED and follow prompts
You apply an automated external defibrillator as soon as someone brings it to you. The D in DRSABCD represents the final action in these basic life support steps for adults, and it significantly increases the person’s chance of survival when used quickly. An AED analyzes the heart’s rhythm and delivers an electrical shock if needed to restore normal beating. You do not need specialized training to use an AED because the device provides clear voice instructions that guide you through every step. Continue CPR until the AED is ready to ensure blood keeps circulating to vital organs.
Turn on and attach the AED
You open the AED case and press the power button immediately. Some models turn on automatically when you open the lid. The device will begin speaking to you straight away, telling you exactly what to do next. Remove or cut away clothing to expose the person’s bare chest. You need direct skin contact for the electrode pads to work properly.
Dry the chest quickly if the person is wet from sweat, water, or other fluids. Moisture prevents the pads from sticking and can reduce shock effectiveness. You may need to wipe the chest with a towel or dry cloth that someone hands you. Shave excess chest hair only if the pads will not stick, using the razor often included in the AED kit, but do not delay pad placement unnecessarily.
Ensure proper pad placement
You peel the backing off both electrode pads and place one pad on the upper right chest, just below the collarbone. Position the second pad on the lower left chest, below and to the side of the left nipple or breast. The pads usually have diagrams showing you exactly where they go. Press firmly around all edges of each pad to ensure complete contact with the skin.
Maintain at least 8 centimeters distance from any implanted medical devices you can see or feel under the skin, such as pacemakers or defibrillators. These appear as small bumps, typically near the collarbone. Remove any medication patches you see on the chest and wipe the area clean before applying the pads.
Correct pad placement creates the electrical pathway through the heart that allows the shock to work.
Follow the voice prompts through shock delivery
The AED will tell you to stop touching the person while it analyzes their heart rhythm. You must ensure nobody is in contact with the patient during analysis. The device will then either say "shock advised" or "no shock advised" based on what it detects. Stand clear and press the shock button if the AED instructs you to deliver a shock. The person’s body may jerk briefly.
Resume CPR immediately after the shock, starting with chest compressions. The AED will continue to guide you, telling you when to pause for another rhythm check every 2 minutes. You keep following the prompts until paramedics arrive or the person begins breathing normally and moving.
Key takeaways
Following the basic life support steps for adults in the correct sequence gives you a systematic framework to respond effectively during cardiac arrest. You start with DRS to secure the scene, check responsiveness, and activate emergency services before attempting any medical intervention. Moving through ABC ensures you manage the airway properly, assess breathing accurately, and deliver CPR at the correct 30:2 ratio without missing critical actions. The AED application completes the DRSABCD sequence and provides the person’s best chance of survival when you apply it within minutes of collapse.
Regular hands-on practice maintains your confidence and skill quality when you face a real emergency. Your compressions need adequate depth of at least 5 centimeters, a rate of 100 to 120 per minute, and complete chest recoil between pushes to circulate blood effectively. The 30:2 cycle balances continuous compressions with essential oxygenation through rescue breaths.
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