Don't Check for a Pulse
Current CPR guidelines don't require a layperson to check a victim's pulse before starting CPR. Why not? Because the average person has a lot of trouble finding and accurately determining a pulse. Think about how difficult it can be to find your own pulse, and then imagine trying to repeat the process on an unresponsive person. Skipping an initial pulse check simplifies CPR and saves valuable time; every minute that you delay starting CPR reduces the odds that the victim will survive.
What should you do to help a seemingly unconscious victim? As we mentioned previously, the first thing you do is determine whether or not the victim is really unconscious. Call out to them, tap them and gently shake them to try and provoke a response. However, you should never shake an infant, even if you suspect he or she is unconscious.
You also should check for signs of breathing. If a person looks slightly blue in the face or if their chest is not rising and falling, there's a good chance they've stopped breathing and will need CPR. If you perform CPR on someone who does not need it, you could actually do damage, so be certain before you begin.
If you suspect someone is unconscious and you can't rouse them, the very next thing to do is have someone call 911 so paramedics will be on their way while you are performing CPR. This is very important because, with the exception of choking, CPR doesn't address the underlying causes of cardiac arrest and other breathing emergencies. It is only meant to buy time until the victim can get intensive medical care.
After you've called for medical assistance, you should begin CPR. In order for CPR to work, the person must be lying on his or her back on a hard, flat surface. If he or she is face down, gently roll him or her toward you while, supporting the neck. Once the person is on their back, you can then use the C-A-B method, which stands for:
- Circulation -- start chest compressions
- Airway -- clear obstructed airways
- Breathing -- perform mouth-to-mouth or mouth-to-nose breathing
Step one ("circulation") is the only one you should perform if you have no training in CPR -- it's called the hands-only method and we discuss it in detail next.