When to Perform CPR: 7 Key Situations You Should Know

Knowing when to perform Cardiopulmonary Resuscitation is crucial as it is the first line of defense in maintaining blood circulation and oxygenation in someone experiencing a cardiac arrest or respiratory failure. If you know how to look for signs that someone needs CPR, you cut out the speculation and respond quickly. In this article, we will explore the key situations when CPR should be administered and the importance of timely action in saving lives.  As a rule of thumb after 4 minutes of rescue breathing if there is no pulse you should being CPR

Breathing and pulse are the two critical factors in determining whether someone needs CPR. If a person isn’t breathing or doesn’t have a pulse, you need to perform CPR immediately. Here are the situations where a victim might need CPR:

  1. When someone is unconscious
  2. Cardiac arrest
  3. Choking
  4. Electrocution
  5. Drowning
  6. Drug Overdose
  7. Suffocation
when to perform cpr

1. When someone is unconscious

When a patient is unconscious and non-responsive, CPR should be performed immediately. If you see an unconscious victim, try to wake the victim. If unsuccessful, check if the victim is breathing normally or has a pulse. If there’s no pulse, the victim’s heart have stopped. The American Heart Association and Emergency Cardiovascular Care recommend that you begin CPR if the person is unresponsive. If their condition becomes unstable because you did not intervene, the victim loses control of their breathing.


2. Cardiac Arrest

The most common scenario in which CPR is needed is during a cardiac arrest. Cardiac arrest occurs when the heart suddenly stops pumping blood effectively. This happens due to various reasons, including a heart attack, arrhythmia, or other heart-related issues. When someone experiences cardiac arrest, their breathing will cease, and they will lose consciousness. In this situation, immediate CPR is crucial to maintain blood flow to the vital organs until professional medical help arrives.


3. Choking

Choking is a life-threatening emergency that occurs when an object obstructs the airway, preventing air flow into the lungs. In cases of severe choking, the person becomes unconscious. If this happens, it is crucial to perform CPR immediately to maintain blood flow and oxygenation. However, it is essential to perform a quick check to ensure that there is no pulse before initiating CPR in a choking victim.

 4. Electrocution 

Electrocution disrupts the heart's electrical system, leading to cardiac arrest. If someone is electrocuted and becomes unresponsive or loses consciousness, begin CPR immediately. It is important to ensure the safety of both the victim and the rescuer before administering CPR, especially in cases involving electrical hazards.


5. Drowning

Drowning is another situation where CPR should be administered promptly. When a person is submerged in water and unable to breathe, their oxygen levels rapidly decrease, which leads to cardiac arrest. After pulling the victim out of the water, it is essential to start CPR if the victim is unresponsive and not breathing. CPR helps restore oxygen circulation to the body, increasing the chances of survival until advanced medical assistance arrives.

Due to the conditions of near-drowning, the American Heart Association recommends that rescuers deliver two rescue breaths first and then begin the cycles of chest compressions and mouth-to-mouth breathing as directed in the CPR guidelines. Perform 30 chest compressions at 100-120 compressions per minute, about 2 inches deep, followed by two breaths.


6. Drug Overdose

Drug overdoses, especially opioids like heroin or synthetic opioids, leads to respiratory failure and unconsciousness. In such situations, CPR is necessary to keep the person alive until medical professionals arrive. If you suspect a drug overdose and the person is unresponsive, check for breathing and a pulse. If there is no breathing or pulse, start CPR immediately.


 7. Suffocation

Suffocation occurs due to various reasons, including being trapped in an airtight space or having an object obstruct the airway. If someone is found unconscious due to suffocation, start CPR if they are not breathing or do not have a pulse. CPR helps maintain oxygen circulation while efforts are made to remove the suffocation source.

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When should you not perform CPR?

CPR is a life-saving technique, but there are specific situations when it should not be performed. It's important to be aware of these circumstances to avoid potential harm to the victim and yourself:

  • Obvious Signs of Life: If the victim is conscious, breathing normally, or displaying any other clear signs of life, CPR should not be administered. In such cases, it's essential to monitor the person and seek medical assistance if needed.
  • Do Not Resuscitate (DNR) Orders: If the victim has a valid Do Not Resuscitate (DNR) order or a legally binding advance directive indicating their wish to avoid CPR, you should respect their wishes and not perform CPR. Always check for these documents if available.
  • No Permission: Before starting CPR you are legally required to ask  the person before you touch a person if they say no, you should not perform CPR
  • Rigor Mortis or Decomposition: In situations where the victim is obviously deceased and has entered the stages of rigor mortis (stiffening of the body) or decomposition, attempting CPR is futile and not appropriate.
  • Terminal Illness with No Chance of Recovery: If the victim has a terminal illness and is in the final stages of life with no chance of recovery, it is inappropriate to start CPR. In such cases, medical professionals and family members should be consulted to make the best decision for the patient's comfort and dignity.
  • Highly Contagious Diseases: In cases of highly contagious diseases, such as certain viral infections (e.g., Ebola), it's not advisable to perform CPR without appropriate protective measures. The safety of the rescuer and the risk of disease transmission should be considered.


Remember that CPR should be administered with care, and it's always recommended to call for professional medical assistance as soon as possible when someone is in distress. In situations of uncertainty, it's better to err on the side of caution and seek help from trained medical personnel.

Why are the first few minutes the most important for giving CPR?

The first few minutes are the most crucial for giving CPR because, during this initial period, the heart has typically gone into a state of cardiac arrest, meaning it has stopped pumping blood effectively. Without immediate CPR to manually circulate oxygenated blood to vital organs like the brain, irreversible damage occurs within just a few minutes.

Effective CPR during these critical minutes buys time and increase the chances of a successful resuscitation once professional medical help arrives. Early intervention significantly improves the likelihood of survival and reduces the risk of long-term complications resulting from oxygen deprivation to the brain and other vital tissues. Therefore, swift action in administering CPR is paramount in saving a person's life during a heart attack.

When to Stop CPR?

Deciding to stop CPR has to be determined depending on the emergency. If you’re administering CPR and see apparent signs of life, such as responsiveness, normal breathing, or coughing, stop giving CPR. Other situations where you need to stop CPR are as follows:

  • When there’s a fire, the traffic gets dangerous, or a storm.
  • When the emergency medical services arrive to take over.
  • When an Automated External Defibrillator becomes available.
  • If you feel exhausted.


Do you perform CPR if there is a pulse?

No, you should not perform CPR if there is a pulse. CPR is specifically designed for individuals who are in cardiac arrest, meaning their heart has stopped beating effectively, and there is no detectable pulse.

When assessing a person's need for CPR, always check for the presence of a pulse first. If you find a pulse, it indicates that the heart is still functioning, and you should not initiate CPR. Instead, monitor the person's condition and provide any necessary first aid or assistance based on their specific medical issue.


when to perform cpr

What happens if you give CPR to someone who doesn't need it?

Performing CPR on someone with a pulse or who doesn't need it potentially cause harm to the individual. It leads to physical injuries, psychological distress, wasted time, and potential legal consequences. It's vital to carefully assess the victim for responsiveness and normal breathing before initiating CPR. If in doubt, call for professional medical assistance and follow their guidance to avoid unnecessary harm.

CPR is an intensive and invasive procedure designed for individuals who are experiencing cardiac arrest or respiratory failure, situations where the heart has stopped beating effectively, or the person has stopped breathing.


When Do You Need to Perform Hands-Only CPR?

Hands-Only CPR is CPR without rescue breathing. It is recommended for use by untrained bystanders who see an adult suddenly collapse in an out-of-hospital setting. Hands-only CPR reduces the time to initiation of CPR and deliver a greater number of uninterrupted chest compressions for the first few minutes after the out-of-hospital cardiac arrest. The CPR hand placement and ratio is same with standard CPR.

How Does CPR Training Prepare You to Recognize When CPR Is Necessary?

CPR training begins with understanding when to perform CPR, which is crucial in emergency situations where someone is unresponsive and not breathing. CPR training prepares individuals to recognize when CPR is necessary by teaching them to identify signs of cardiac arrest, such as unresponsiveness, absence of breathing, or abnormal breathing patterns. Participants learn to assess the victim's condition quickly and determine if CPR is required based on established guidelines and protocols. Additionally, training emphasizes the importance of activating emergency medical services (EMS) promptly when CPR is indicated.

What Are the Latest CPR Training Guidelines on When to Initiate CPR?

The latest CPR training guidelines recommend initiating CPR when an adult or child is unresponsive and not breathing normally. Specifically, if the victim is not breathing or only gasping, rescuers should immediately begin chest compressions at a rate of 100 to 120 compressions per minute. Rescue breaths are also provided in a ratio of 30 compressions to 2 breaths for adults and children. For infants, the ratio is 30:2, but rescuers should use their cheek to check for breathing instead of looking for chest rise.

How Is the Importance of Timing Emphasized in Deciding When to Perform CPR?

During CPR training, the importance of timing in deciding when to perform CPR is emphasized through practical instruction. Trainees learn that early initiation of CPR significantly improves outcomes for cardiac arrest victims by maintaining blood circulation and oxygenation. They are taught to act quickly and decisively, understanding that every minute without CPR decreases the chances of survival. Training reinforces the critical concept of "push hard, push fast" to maximize blood flow and increase the likelihood of successful resuscitation. Additionally, trainees are educated on the importance of coordinating CPR efforts with activating EMS to ensure timely advanced medical care.

Take an American Heart Association certification course in CPR and First Aid, to learn CPR. You will know how to respond to various emergencies and use an AED or Automated External Defibrillator. If you want to test your knowledge, try taking a free AHA BLS practice test online. You may also take same day bls certification. If you are in the healthcare industry and needs to renew your current certification, take bls recertification for healthcare providers online.