Cardiopulmonary Resuscitation (CPR) is an emergency procedure performed when someone’s breathing or heartbeat has stopped. Knowing when to initiate CPR is important, but understanding when to appropriately stop is equally significant.
The Purpose of CPR and Initial Assessment
CPR manually circulates oxygen-rich blood to the brain and other organs when the heart stops. This delays tissue death and improves resuscitation chances. A lay rescuer should start CPR if an adult collapses, is unresponsive, and is not breathing normally or is only gasping. Immediate action improves outcomes, as permanent brain damage can occur in as little as four minutes if blood flow ceases.
Recognizing the need for intervention is the first step. CPR involves chest compressions, often combined with rescue breaths, to restore blood flow and oxygenation. For untrained rescuers, hands-only CPR, focusing solely on continuous chest compressions, is recommended. This maintains blood flow to the brain and heart.
Situations for Continuing CPR
Once CPR begins, a lay rescuer should continue without interruption. Consistent, high-quality chest compressions maintain blood flow to the brain and heart. Interruptions should be minimized, ideally lasting no more than 10 seconds. This continuous effort improves the chance of survival until advanced medical care arrives.
For trained rescuers, CPR involves cycles of 30 chest compressions followed by two rescue breaths. Continuous chest compressions are the most important component, keeping oxygen-rich blood circulating. Rescuers should continue these efforts until specific criteria for stopping are met.
Clear Reasons to Stop CPR
A lay rescuer should stop CPR only under specific circumstances. One reason to cease compressions is if the person shows signs of life, such as normal breathing, purposeful movement, or responding to stimuli. If the person regains consciousness, CPR should be stopped, and they should be monitored closely.
Another reason to stop is if the rescuer becomes physically exhausted and can no longer deliver effective chest compressions. Ineffective compressions are not beneficial. If another trained individual is present, rescuers should switch positions every two minutes to maintain quality and prevent fatigue.
Rescuer safety means CPR should stop if the scene becomes dangerous. Environmental hazards like fire, smoke, collapsing structures, or active threats require ceasing CPR for the rescuer’s well-being. The rescuer should move themselves and, if possible, the person to a safer location.
Finally, if a valid Do Not Resuscitate (DNR) order is presented and confirmed, CPR should be stopped. A DNR order is a legal document indicating a person’s wish not to receive CPR if their heart or breathing stops. The presence of such an order means resuscitation efforts should cease.
Handing Over to Professionals
The most common reason for a lay rescuer to stop CPR is the arrival of trained medical professionals. Paramedics, EMTs, or other healthcare providers are equipped to take over and provide advanced life support. The lay rescuer should continue CPR until specifically instructed by the arriving professionals to stop.
Upon their arrival, the lay rescuer should communicate the situation to the medical team. This includes details like when CPR was initiated, how long it was performed, and any changes observed. This information helps medical professionals assess the situation and determine next steps.