How to Decide When to Perform CPR

How to Decide When to Perform CPR

In the face of a medical emergency, staying calm and knowing how to react can make a critical difference. Cardiopulmonary resuscitation (CPR) is a lifesaving technique that can keep oxygenated blood flowing throughout the body when someone’s heart stops beating or they are not breathing. Knowing When to Perform CPR is crucial for anyone who wants to be prepared to help in such a situation.

This article will guide you through the key signs that indicate the need for CPR and empower you to take decisive action.

The Importance of Early Intervention

The human brain is incredibly sensitive to oxygen deprivation. When the heart stops beating, blood flow ceases, and vital organs like the brain become starved of oxygen. Brain cells begin to die within minutes, and permanent brain damage or death can occur within 4-6 minutes without intervention.

Performing CPR helps circulate oxygen-rich blood throughout the body, even when the heart is not pumping effectively. This precious time window allows emergency medical services to arrive and take over with advanced resuscitation techniques.

By recognizing the signs that someone needs CPR and acting swiftly, you can significantly increase their chances of survival and minimize potential brain damage.

When to Perform CPR: Key Signs

1. Unconsciousness and Unresponsiveness

The first and most crucial sign that someone might need CPR is unconsciousness and unresponsiveness. This means they are not awake and do not react to stimuli like shouting, shaking, or pinching.

2. Absence of Breathing (Apnea) or Abnormal Breathing

Carefully check for breathing. Look for chest rise and fall, or feel for air coming out of the nose or mouth. If the person is not breathing normally, or their breathing is shallow, gasping, or labored, they may require CPR.

3. Lack of Pulse

Feeling for a pulse can be challenging in a stressful situation. However, if you are trained in pulse checks, and you cannot detect a pulse after several attempts, CPR is necessary.

Here’s a crucial point to remember: If you are unsure whether someone needs CPR, it’s always better to err on the side of caution and begin CPR. Studies have shown that performing CPR on someone who doesn’t need it is far less risky than not performing it on someone who does.

Scenarios Where CPR Might Be Needed

Certain situations have a higher likelihood of requiring CPR due to the potential for cardiac arrest or respiratory failure. Here are some examples:

  • Cardiac arrest: This occurs when the heart’s electrical impulses malfunction, causing it to stop beating effectively.
  • Choking: A blocked airway can prevent oxygen from reaching the lungs, leading to respiratory failure and cardiac arrest.
  • Drowning: Near-drowning incidents can cause a lack of oxygen and cardiac arrest.
  • Electrocution: Electrical shock can disrupt the heart’s rhythm and cause it to stop.
  • Drug overdose: Overdoses can depress the respiratory system and slow down the heart rate, potentially leading to cardiac arrest.
  • Smoke inhalation: Inhalation of smoke and toxic fumes can damage the lungs and cause respiratory failure.
  • Severe allergic reactions: Anaphylaxis can cause swelling of the airway and difficulty breathing.

It’s important to note that this is not an exhaustive list. CPR can be necessary in any situation where someone is unconscious, not breathing normally, and does not have a pulse.

What to Do When You Suspect Someone Needs CPR

If you encounter someone who is unconscious, unresponsive, and not breathing normally, here are the steps to take:

  1. Call for Help Immediately: Activate the emergency medical services (EMS) by dialing the appropriate emergency number for your location. If someone else is present, delegate this task to them.

  2. Position the Person: Gently lay the person flat on a firm, stable surface.

  3. Open the Airway: Tilt the head back and lift the chin to open the airway.

  4. Check for Breathing: Look, listen, and feel for signs of breathing for no more than 10 seconds.

  5. Begin CPR (if needed): If the person is not breathing normally, start CPR compressions. Push hard and fast in the center of the chest at a rate of 100-120 compressions per minute. If you are trained in rescue breaths, you can incorporate them into the CPR cycle at a ratio of 30 compressions to 2 breaths.

  6. Continue CPR: Maintain CPR cycles until help arrives or the person starts breathing normally.

Additional Considerations

  • CPR Training (continued): confidence to act effectively in a stressful situation. Training covers essential aspects like proper hand placement for chest compressions, rescue breathing techniques, and how to adjust CPR for infants and children.
  • Using an AED: An Automated External Defibrillator (AED) is a portable device that can analyze the heart rhythm and deliver an electrical shock to restore a normal rhythm in certain cases of cardiac arrest. If an AED is available, use it after calling for help and performing CPR.
  • Scene Safety: Before approaching an unconscious person, ensure the scene is safe for yourself and others. Look for potential hazards like electrical wires, traffic, or falling objects. If the scene is unsafe, do not put yourself at risk. Call for help from a safe distance.
  • Legal Considerations: In many regions, there are Good Samaritan laws that protect people who act in good faith to help others in an emergency. These laws generally shield individuals from liability if their actions are reasonable and do not cause more harm.
  • Psychological Impact: Witnessing a medical emergency and performing CPR can be a stressful experience. It’s important to seek support from friends, family, or mental health professionals if you experience emotional distress after a CPR event.

When NOT to Perform CPR

While CPR is a valuable lifesaving technique, there are situations where it may not be appropriate. Here are some instances:

  • The person is already receiving medical attention: If medical professionals are present and attending to the person, it’s best to allow them to take over.
  • The person is clearly deceased: Rigor mortis (stiffening of the body) and obvious signs of decomposition indicate that CPR is not necessary.
  • The person has a DNR (Do Not Resuscitate) order: A DNR order is a legal document that specifies a person’s wishes regarding CPR in the event of cardiac arrest. If you are aware of a DNR order in place, respect the patient’s wishes.

Remember, these are just guidelines. If you are unsure whether someone needs CPR, it’s always better to err on the side of caution and begin CPR.


Knowing When to Perform CPR is a valuable skill that can empower you to make a lifesaving difference in an emergency. By recognizing the signs of cardiac arrest or respiratory failure and taking immediate action, you can significantly increase a person’s chances of survival.

Consider enrolling in a CPR training course to gain the knowledge and confidence to perform CPR effectively. Even basic CPR skills can be life-saving.

Let’s all work together to create a more prepared and responsive community by equipping ourselves with the knowledge and skills to act in critical situations.