How Do You Know If Someone Needs CPR?
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Fact checked by Nick Blackmer
Key Takeaways
Recognizing that someone needs CPR and being able to do it properly can be the difference between life and death.
If someone is breathing, they do not need CPR.
You don’t have to be a healthcare professional to give CPR. Training is available through the American Heart Association and Red Cross.
In the United States, around 350,000 people go into cardiac arrest outside of the hospital every year. While cardiopulmonary resuscitation (CPR) is an effective way to help in this situation, only about 40% of people who go into cardiac arrest receive bystander CPR before help arrives.
Knowing how to tell if someone needs CPR and being able to give it can buy a person time before emergency responders arrive—sometimes, it’s the difference between life and death. But not everyone knows when it’s appropriate or what to do.
Here’s how to quickly assess whether or not someone is a candidate for CPR.
Related: Women Get Bystander CPR Less Than Men
What Happens When Someone Goes Into Cardiac Arrest?
Cardiac arrest means that the heart stops pumping blood to the rest of the body. Someone who is in cardiac arrest will have no pulse.
A person can go into cardiac arrest for many reasons, including:
A heart attack or blockage in the arteries that supply blood flow to the heart
Abnormal heart rhythms (arrhythmias)
Illicit drug use or overdose
Structural heart abnormalities (e.g., hypertrophic cardiomyopathy)
Respiratory failure or arrest
Severe electrolyte imbalance
Chest trauma
Cardiac Arrest vs. Heart Attack
A heart attack is not the same as cardiac arrest—however, a person who has had a heart attack may go into cardiac arrest.
What Does CPR Do?
When a person goes into cardiac arrest, blood isn’t getting to the rest of their body. That means no oxygen is circulating to the organs and tissues. The brain is the first organ to feel the effects of the lack of oxygen. Brain cells start to die within minutes and prolonged cardiac arrest can cause irreversible brain damage.
Chest compressions in CPR do the work of moving blood around the body that the heart would normally do by pumping. Doing compressions helps get oxygen to the brain and other vital organs.
Even if they survive an out-of-hospital cardiac arrest, a person may have long-term effects, like a reduced ability to do their usual activities, severe fatigue, anxiety, depression, and a lower quality of life.
Related: Signs of Cardiac Arrest
When to Start CPR
If you witness someone going into cardiac arrest, the most important thing is to stay calm and assess the situation.
“When a person is in duress you will want to access the scene first, checking for any safety or hazards that may be harmful to you,” Zack Zarrilli, a paramedic and the founder of SureFireCPR.com, told Verywell.
After you’ve determined it’s safe to help, Zarrilli says the next step is to “tap the person’s shoulder, and shout ‘Are you OK? ’ while looking for normal breathing.”
If the person is conscious and breathing, they do not need CPR. However, if there is no response and the person is not breathing, Zarrilli says to make sure the person “is lying on a firm and flat surface facing upwards” and then start giving them CPR.
You should start CPR whether or not you can feel a pulse. In fact, the American Heart Association does not want people to spend time checking for a pulse. In an emergency, a nervous bystander may confuse their own pulse for that of the person they’re trying to help.
Even if someone is unresponsive and not breathing and still has a pulse, it probably isn’t strong enough to pump blood or it won’t last very long.
If you are alone, call 911 before starting chest compressions. Your goal is to get EMS on the way as soon as possible. Paramedics have medical devices that use electrical currents to correct abnormal heart rhythms (defibrillators). They’re also trained to give cardiac medications.
If there are other people around, point to a specific person and make eye contact with them. In a clear voice, tell them to “Call 911.” If there’s someone else around, you can tell them to look for an automated external defibrillator (AED), which anyone can use.
Related: How to Do CPR
How to Do CPR Chest Compressions
Once you’ve determined that a person needs CPR and it’s safe for you to try to help, you can start giving chest compressions.
Look for the middle of the person’s chest.
Place the heel of one hand at the bottom of the breast bone (sternum) at the nipple line.
Stack your other hand on top and lace your fingers.
Position your body so that your shoulders are directly over your hands, with elbows straight and locked.
Push down hard and fast—you need the person’s chest to go down about 2 inches with each compression. Make sure to let their chest come back up each time before you push down again.
To get blood moving around the person’s body effectively, chest compressions need to be done at a rate of at least 100 beats per minute. To keep that rhythm, think of the beat of these songs:
Stayin’ Alive by The Bee Gees
Another One Bites the Dust by Queen
Crazy in Love by Beyonce and Jay-Z
Sweet Home Alabama by Lynyrd Skynyrd
Rock Your Body by Justin Timberlake
Hips Don’t Lie by Shakira
Doing high-quality chest compressions is physically exhausting. If someone else is around to help, you can switch after you’ve done 30 compressions.
Do You Have to Do Mouth-to-Mouth CPR?
After you do a set of 30 compressions, you can take no more than 10 seconds to give a person two rescue breaths. Rescue breathing is when you breathe air into a person’s mouth to give them oxygen.
Healthcare providers will usually place masks over the patient’s mouth when they are giving air during CPR, and you can buy these masks to have on hand. However, if you’re in a situation where someone needs CPR, you don’t have a mask, and you’re not comfortable giving them mouth-to-mouth, that’s OK.
You do not have to give rescue breaths when you’re doing CPR. Doing chest compressions alone will circulate the oxygen that is in the body until help arrives. Hands-only CPR is better than no CPR at all.
When Should You Not Do CPR?
If someone is conscious and breathing, they don’t need CPR. There are also some specific situations when you should not try to give CPR.
The first is when it would put you in danger. You might be thinking more about trying to help someone, but you need to consider your own safety first.
“Do not begin CPR if the scene is unsafe for the person providing CPR or places the rescuer at risk,” said Zarrilli. “Some unsafe scene examples would be a chemical spill, an uncontrolled fire burning nearby, or an active shooter on a scene.”
Can Kids Get CPR?
Kids and babies can receive CPR, but the technique is a little different than it is for adults. If you do CPR training, you can get certified in infant and child CPR. If a child or baby goes into cardiac arrest, call 911 right away.
Another situation is when a person would not want to get CPR. For example, people with end-stage chronic health conditions may have made a decision with their providers that if they go into cardiac arrest, they do not want any life-sustaining efforts made to save them. This is called a do-not-resuscitate (DNR) order. If you have evidence that someone has a DNR (such as a form from their medical record or a medical alert bracelet), you should not do CPR on them.
If you’re wondering if you’ll get in trouble for giving someone CPR, know that in most places you will be covered by Good Samaritan laws. You should learn about the specific laws in your state so you’ll know how you’ll be protected in the event you try to help someone in an emergency.
How to Learn CPR
The American Heart Association and the American Red Cross offer CPR and AED training for adults, children, and infants. You can do full training in-person or do hybrid courses that combine online learning and a skills evaluation with a trainer. You can also learn other life-saving skills like First Aid. Many workplaces and community first response teams also may offer CPR training.
Read the original article on Verywell Health.
