CPR is usually performed in emergencies such as heart attacks, drownings, or instances of severe respiratory distress if emergency medical services have still not arrived. Your knowledge and actions can make all the difference for the cardiac arrest victim.
Knowing the right moment to start CPR can help save a victim’s life, but recognizing when it’s time to stop is just as important. It might feel counterintuitive to stop giving life-saving measures, but there are specific situations where that is necessary.
By the end of this article, you’ll have a better understanding of balancing determination with the practical considerations that sometimes require CPR to be discontinued. We’ll guide you through each of these scenarios and advise you on when to stop performing CPR.
What is CPR?
CPR is a life-saving procedure used in emergencies where someone’s breathing or heartbeat has stopped. The main goal of CPR is to help oxygenated blood reach the brain and other vital organs. This slows down the decay of tissue and gives you a better chance at successful resuscitation without any neurological consequences for the victim.
You might not know it, but your ability to perform CPR can increase the chances of survival and recovery for victims of cardiac arrest. Studies have shown that if CPR is done immediately after the victim has gone into cardiac arrest, it can significantly improve their chance of survival.
Unfortunately, only 2.4% of the U.S. population receives CPR training annually, leading to lower survival rates in out-of-hospital cardiac arrests. This highlights the importance of widespread CPR knowledge and training.
The CPR Process
Performing CPR involves a sequence of steps that you, as a rescuer, must do quickly and efficiently. You should ensure the scene is safe before checking if the victim is awake and responsive. If the person doesn’t seem to be reacting and isn’t breathing, you must call 911 and then start CPR immediately.
For adults, this involves placing the heel of one hand on the person’s chest, but make sure it’s in the center. Then, you must place your other hand on top and press down hard and fast at a rate of 100 to 120 compressions per minute. For children and infants, the technique often requires using only one hand or two fingers for compressions. Also, there’s no need to press too deeply.
In case you have any CPR training, you can also give the victim rescue breaths, maintaining a balance of 30 compressions to 2 breaths.
Recognizing When CPR is Necessary
Knowing when to do CPR can be the difference between life and death in emergencies. If someone appears unresponsive, you should take the following steps:
- Check their responsiveness by shaking their shoulders and asking if they’re ok.
- If there’s no response, immediately call for emergency help.
- See if they are breathing. Look for regular breathing movements, listen for any signs of breathing, and try to feel if air is leaving their mouth or nose.
- If the victim isn’t breathing normally or only gasping, start CPR immediately.
While you may feel hesitant about performing CPR, know that Florida has a Good Samaritan Act in place to protect bystanders who offer help in good faith. Consent is implied in emergencies when the victim has lost consciousness and can’t respond.
When to Stop Performing CPR
Understanding when to halt CPR is as important as knowing how to perform it. While your goal is to save a life, recognizing the right moment to stop can also be a matter of safety. There are clear signs and scenarios where stopping CPR is the advised course of action.
These include signs of life in the person you’re assisting, your physical limitations, the arrival of emergency medical services (EMS), or if you’re in a dangerous environment that can jeopardize your safety as well.
Signs of Life
If the person shows the return of spontaneous circulation (ROSC), where their heart starts beating, it’s time to pause and check their condition. One study showed that ROSC can happen in 68% of patients, so look out for the telltale signs.
Normal breathing is another critical sign. If the person begins to breathe regularly without assistance, this is a clear indicator that your CPR efforts have been successful, and it’s appropriate to stop and monitor their breathing.
Movement or responsive actions, such as coughing, moving limbs, or opening eyes, also signal that the person is regaining consciousness and that continual CPR might no longer be necessary.
When An AED IS Available
AEDs are portable devices designed to treat sudden cardiac arrest by sending an electric shock to the heart to restore a normal rhythm. These devices can offer a chance to revive the person if CPR alone isn’t leading to ROSC. Most cardiac arrests happen in public spaces, so always check if there is an AED nearby. The AED will give you prompts on what to do next, including when to continue CPR and when to pause for analysis and shocks.
Rescuer Fatigue
Another reason to consider stopping is becoming exhausted. CPR is physically demanding, and there’s a limit to how long you can effectively perform it. A recent study showed that the quality of chest compressions goes down even after one minute of doing CPR.
Continuing beyond what you’re capable of doing can lead to ineffective chest compressions or rescue breaths. It can potentially cause more harm than good. The safety of the rescuer is also important. If you’re exhausted, you’re less able to respond to changes in the situation or to perform other necessary actions.
Emergency Medical Services Have Arrived
Transfer of care is a clear-cut scenario where stopping CPR is necessary. When emergency medical services (EMS) arrive, you can rest assured that professionals will take over. They’re better prepared and have the means to give the victim advanced medical care.
Similarly, if a more qualified individual arrives on the scene and is ready to take over, handing over the responsibility to them is the right decision. This ensures that the person in distress receives the best possible care.
Dangerous Environment
If the environment becomes dangerous, stopping CPR might be the only option. Threats to the rescuer’s safety, such as fire, toxic fumes, or structural instability, mean that you have to stop your CPR efforts and even evacuate the scene. You must remember that your safety is also important. You cannot help someone if you get hurt and become a victim yourself.
Advanced Medical Directives
If you’re faced with a situation where someone has suddenly collapsed, your first instinct might be to start CPR. However, if you already know that the person has a DNR order, you must respect the victim’s wishes. These directives are legal documents prepared in advance. They indicate that the person doesn’t want CPR or other life-saving measures in the event of cardiac arrest or similar life-threatening situations.
Family members or caregivers must inform medical professionals or first responders if the victim has a DNR directive. Ignoring it can lead to legal consequences and emotional distress for the family. So when a DNR is in place, don’t do CPR. Instead, try to provide comfort and support until professional help arrives or the situation is resolved.
Clear Signs of Death
Lastly, there are clear signs of death that, when present, indicate that CPR should be ceased. They include:
- Rigor Mortis. The stiffening of the body’s muscles post-death
- Lividity. The pooling of blood in the lower part of the body
- Decomposition. When the victim’s body has started to deteriorate
Recognizing these signs requires sensitivity and respect for the deceased. It’s a delicate situation; when these signs are present and easy to spot, it’s time to stop CPR. This decision isn’t easy and must be approached with the utmost respect for the victim and their dignity.
The Final Stop
Understanding the right techniques for performing CPR and recognizing when it’s time to stop are key components of effective emergency response. You should consider stopping CPR if professional help arrives, the person shows signs of recovery, or if you’re physically unable to continue.
But stopping your CPR efforts isn’t giving up. It’s making the right call based on the situation at hand. Getting CPR certified in Wesley Chapel will give you the knowledge and skills to save a life and teach you when to stop performing CPR – for your and the victim’s benefit as well. So, take the step to get trained, get certified, and be ready to make a difference when it truly matters.