An adult patient is not breathing and does not have a carotid pulse. What should you do first?

• A. Start Chest compressions
• B. Call for help
• C. Ventilate with breaths
• D. Check pulse

Answer: (A)

When an adult is unresponsive, not breathing, and has no pulse, the priority is to start chest compressions immediately. Not having a pulse means circulation has stopped, so delivering compressions provides blood flow to the brain and other vital organs while help is arranged. Ventilations are important, but without circulation they don’t help oxygenate the brain effectively, so compressions come first. Pulse checks can be unreliable and waste precious seconds, which is why you don’t delay starting CPR to verify the pulse. If someone else is available, have them call emergency services and get an AED while you begin compressions, and continue until professional help arrives or an advanced defibrillation/airway is provided.