When an individual is in need of a medical emergency procedure, such as CPR, it can be performed by medically trained professionals, persons qualified to perform basic first aid, and untrained bystanders. This is due to the fact that it takes time for paramedics to arrive at the scene and transport the victim to the nearby hospital or medical facility.
However, there are situations when such procedures are not needed, whether because they’d cause more damage or because it’s too late. Not every medical emergency requires CPR to be performed on the victim. In some cases, doing so can lead to further complications.
So, when should you not perform CPR? This article discusses cases where CPR may be redundant and what to do instead.
When Is It Safe to Perform CPR?
Sometimes the environment or other life-threatening circumstances make it difficult to perform CPR. In addition, if the victim hasn’t shown any signs of life for an extended time or EMTs have arrived and taken over, bystanders are free of responsibility.
However, situations can vary, and bystanders are sometimes left wondering what to do. In order to understand when CPR cannot be performed, you need to know when it’s the right time and place.
You can perform CPR on a person in need of it when:
- A heart attack leads to cardiac arrest
- You’ve made sure that they are just unconscious and not deceased.
- The victim is lying on a flat and firm surface.
- Neither you nor the victim are in immediate danger.
- You and the victim are in an area that is safe from oncoming traffic or debris.
- The proper authorities have been notified.
Untrained bystanders are also allowed to give CPR. However, it’s recommended that they stick to hands-only CPR, as mouth-to-mouth is required in a small number of instances. If you have a form of certification, provide CPR accordingly.
When Should CPR Be Avoided?
Understanding whether a victim is in need of CPR is a crucial step. There are various situations where it’s neither safe nor advisable to perform CPR. This can be due to several kinds of factors depending on the situation at hand.
So, when should you not perform CPR? The examples listed below are situations where further information or assistance is needed to determine whether the victim is in need of CPR:
- Victim shows obvious signs that they are alive.
- The surrounding area is too dangerous.
- Victim shows absolutely no signs of life.
- First responders have arrived at the scene.
- You’ve begun to become fatigued.
Signs of Life Are Visible
The first step one should take when faced with a possible medical emergency is to check for signs of life. If the person is unconscious or unresponsive, you should immediately proceed to giving CPR. If the individual is breathing and has a pulse, then there is no need to do anything other than wait for help to arrive.
In circumstances where resuscitation proves successful, you may have missed crucial hints that they no longer need CPR. While the victims might not start talking and walking, there are other obvious signs that may be displayed that you might not notice. The following signs are ones you need to look to out for:
- The CPR recipient has started to breathe on their own.
- Their pulse has returned.
- The person tries to communicate with you.
- They show signs of deliberate movement and attempts to move their limbs.
- They regain consciousness and open their eyes.
In some cases, finding yourself in a compromising situation is a valid reason not to give CPR. More specifically, you should avoid CPR if you’re under threat of an attack, a traffic accident, a natural disaster, etc.
These situations can be dangerous to both yourself and others, including first responders.
In such circumstances, with victims in hazardous areas, your personal safety comes first. These areas aren’t safe for anyone, CPR providers included. Moving the victim away from possible or incoming dangers takes priority.
Ask for assistance if there are others near you to help move the individual to a better location away from traffic or debris. Once safely relocated, you may check their condition and perform CPR if necessary, but not before calling 911.
No Signs of Life Present
In some unfortunate cases, the victim may not have survived the medical emergency. People with knowledge of first aid training are taught to perform CPR if the person is not breathing or has no heartbeat, but sometimes, help may be too late.
As you quickly assess whether a person is in need of cardiopulmonary resuscitation, there are specific clues to keep an eye out for. These are the signs to look out for, as they will show whether the individual is dead or not.
When trying to determine if an individual is dead, look for:
- Obvious death caused by visible injuries
- Their pupils are not reactive and may be slightly dilated.
- Their body is cold and stiff to the touch.
- A pulse cannot be found.
Professional Help Has Arrived
When trying to help a casualty, your top priority is to call the proper authorities. Paramedics and first responders will handle all medical emergencies, but you can still do your part to keep the victim stable until a defibrillator is available. Either you or other people nearby should call 911 and ask for an ambulance to be sent to your location.
Should an ambulance arrive before or just as you’ve begun the procedure, stop and step aside. The paramedics will handle the situation from then on, and all your assistance will not be needed unless requested. Depending on the situation at hand, you may only need to focus on your own safety.
You Are Experiencing Fatigue
In the past few decades, the recommended rate of chest compressions has been changing. People would give 60 compressions per minute in the 60s. On the other hand, people today are advised to give at least 100-120 compressions per minute. There’s no set upper limit.
Research suggests that the longer a person is able to receive CPR, the better their blood flow will be. Cardiopulmonary resuscitation usually lasts about 10 minutes, but in some cases, it can even take up to an hour for the person to be resuscitated. As such, performing CPR properly can lead to you becoming fatigued, as it is a physically and mentally demanding procedure.
The more tired you get, the less likely you will be able to continue to give the person the proper chest compressions and breaths. If there are other people in the area, you can ask them to assist you. As this is a responsibility among members of society, people should be willing to help you. Other individuals and yourself can take turns and perform CPR the right way for a longer period of time.
Therefore, if you’ve reached the point of physical fatigue, you should stop the resuscitation. The more tired you are, the harder it will be to perform CPR with success.
What Can You Do Instead?
In the event that you either cannot or shouldn’t resuscitate a person, you should follow these steps:
- Call 911 and request that they send an ambulance to your location.
- Check for signs of life.
- Move the individual to a safe location if it is needed.
- Wait by them until paramedics or the proper authorities show up.
Conclusion: When Should You Not Perform CPR
CPR is a life-saving treatment that, under most circumstances, should be performed by bystanders as much as medical personnel. Many people have died before they could reach the hospital, and taking the initiative to perform resuscitation could be what saves their lives. However, there are situations where you must stop performing CPR for the victim’s and/or your own safety.
This could be either because the individual is responsive and in no need of medical intervention because they have already passed away. In some cases, it could be that the area you are in is too dangerous to perform such an intense procedure.
Additionally, you could be too physically tired to continue giving the appropriate chest compression rate. These are the circumstances to keep in mind before you begin performing CPR on a victim.