CPR special situations arise whenever the person who needs resuscitation, the space around them, or their body forces you to adapt what you have been taught. Cardiopulmonary resuscitation training assumes a clear set of conditions: a firm floor, open space, and an average adult body, but real emergencies do not guarantee any of those things. The people you are most likely to provide CPR are the people already in your life, and their age, size, pregnancy, mobility, or surroundings may all demand something different from what you practised on a manikin. Knowing the steps for conventional CPR is the foundation, but the gap between that foundation and traumatic cardiac arrest in CPR special situations is where hesitation lives.
CPR on a Pregnant Person
When a pregnant person lies flat on their back, the weight of the uterus presses on the major blood vessels in the abdomen. This compression reduces circulation to the heart, which can make cardiac compressions less productive.
You should still place the person on their back and begin CPR using the standard 30:2 ratio of compressions to rescue breaths. Once compressions are underway place a towel, cushion, or folded clothing under the right hip to tilt the pelvis 15 to 30 degrees to the left, and their shoulders remaining.
Ideally, you should have someone else do this for you to not interrupt CPR. If you are alone, or if the tilt makes compressions difficult, abandon it and continue standard CPR on a flat surface. Compressions on a flat back are better than poor compressions on a tilted body.
CPR on a Person in a Wheelchair
When someone in a wheelchair becomes unresponsive and stops breathing, a flat, firm surface is still the ideal place to start CPR. Lock the wheelchair brakes, support their weight, and ease them onto their back on the floor. If a second bystander is available, one person can support the upper body while the other guides the legs.
If you cannot move the person, lock the brakes and recline the chair as far as it will go. Begin compressions in the chair. You may need to use more effort to achieve adequate compression depth, and the chair may shift under your hands, so brace it against a wall or have someone hold it steady.
CPR on Infants and Babies
CPR on infants and children requires smaller, more controlled movements than adult CPR. For infants under 12 months, the depth of chest compressions changes from 5cm to 4cm. Ideally, you should also use two fingers to prefer the compressions rather than your whole hand.
Rescue breaths also change. Due to infants’ developing airways, no head tilt is required. Your mouth must be sealed over the infant’s nose and mouth, not just their mouth, and instead of two full breaths you should only deliver gentle puffs of air.
An AED analyses whether the heart is in a shockable rhythm before it delivers a shock. Outside of specialised paediatric pads, defibrillation should not be used on infants under the age of 1 year, and these should only be used by someone with professional medical training, not bystanders.
CPR in Confined Spaces
Someone can stop breathing on an aeroplane, in a bathroom stall, on a hiking trail, or in any space where you cannot kneel beside them in the conventional position. What changes in these CPR special situations is how you position yourself relative to the person’s chest.
Over-the-head CPR. If you cannot kneel at the person’s side, position yourself behind their head. Place the heel of your hand on the centre of the chest with your fingers pointing toward their feet, stack your other hand on top, and compress with straight arms.
Straddle CPR. When space is too narrow to reach from the head or the side, straddle the person’s hips and compress the chest from above.
Learn CPR for Special Circumstances
A medical emergency that demands CPR does not follow a script, and the person who needs resuscitation may not match the scenario you’ve been training for. What changes in CPR special situations are the small, critical adjustments that keep those principles working when circumstances push back. Hands-on CPR training puts those adjustments into your muscle memory, so your response is shaped by practice rather than hesitation so your response is shaped by practice rather than hesitation in real life CPR special situations.
FAQs
Can I Get CPR Training Through a First Aid Course?
Yes. In Australia, the nationally recognised unit HLTAID009 Provide Cardiopulmonary Resuscitation is included within broader first aid courses such as HLTAID011 Provide First Aid training. You can also enrol in the standalone CPR course if you only want to complete the resuscitation component or need annual refresher training.
What Items Should Be in a First Aid Kit?
A first aid kit should include adhesive dressings, sterile gauze, bandages, disposable gloves, adhesive tape, saline solution, tweezers, and scissors.
Can I Hurt Someone by Performing CPR?
Yes, chest compressions should be forceful and can risk breaking ribs. However, ribs can heal and the alternative could be death. Furthermore, Australia has Good Samaritan legislation protecting when you provide emergency help in good faith.