If an adult patient is unresponsive with no pulse, what is your first action?

• A. Check pulse for 10 seconds.
• B. Give rescue breaths only.
• C. Check airway.
• D. Begin high-quality CPR immediately and call for a defibrillator.

Answer: (D)

When an adult is unresponsive with no pulse, the priority is to restore circulation as quickly as possible. Start high-quality chest compressions immediately to generate blood flow to the brain and heart while you activate emergency services and obtain an automated external defibrillator. Early CPR buys time for vital organs, and defibrillation should be delivered as soon as the AED is ready if the rhythm is shockable. Delaying CPR to check for a pulse can waste precious seconds and is often unreliable, since distinguishing a pulse in an unresponsive person is difficult. Giving rescue breaths alone won’t circulate blood, which is why compressions are essential even if you’re unsure about breaths. Open the airway as part of the process, but do not let that step delay compressions; if you’re trained, continue with the recommended pattern (compressions with breaths). If you’re not trained to give breaths, provide Hands-Only CPR to keep the blood moving until help arrives.