CPR or pulse check: What to do when someone is unconscious

When encountering an unconscious individual, initial thoughts may lead one to check for a pulse. However, if not medically trained, should time be spent searching for a pulse before initiating CPR? We consulted Dr Swarup Swaraj Pal, Senior Consultant, Cardiovascular and Thoracic Surgeon at Gleneagles Hospitals Parel, to clarify the appropriate actions for bystanders upon discovering an unconscious person.

Disclaimer: This article relies on information from public sources and expert consultations. Always seek advice from a healthcare professional before taking any action.

If faced with an unconscious person, the priority for an untrained bystander should be to immediately assess responsiveness and breathing, rather than attempting to locate a pulse. Here are the essential steps to follow:

1. Ensure the environment is safe.

2. Assess whether the individual responds. Gently tap the person and speak loudly to provoke a response.

3. Observe breathing patterns. Not all breaths are normal; gasping, irregular, or noisy breathing does not constitute normal breathing.

4. If the person is unresponsive and not breathing normally, treat it as a medical emergency and do not waste time trying to find a pulse.

5. Immediately call for emergency medical assistance and commence chest compressions.

6. If an Automated External Defibrillator (AED) is accessible, use it promptly and adhere to its voice instructions.

Dr Pal emphasizes that for an untrained bystander, attempting to find a pulse can be challenging and potentially delay critical CPR. In a cardiac arrest, every second counts, making it crucial to act swiftly. If uncertain about the individual's condition, it is better to prompt action than to lose valuable time attempting to make an accurate assessment.