Many nurses have a lot of questions concerning performing chest compression-only CPR. Here is your comprehensive guide in different circumstances.

Signs of a Primary Cardiac Arrest

Signing up for basic life support training programmes means that you will be well aware of all the most common symptoms of a primary
cardiac arrest. Some of the symptoms include:

Sudden Collapse

The person may seem fine and healthy and then collapses all of a sudden.


You will also learn during basic life support training programmes that the best way of checking for responsiveness is by shouting the victim’s name or if they are okay and shaking them. You can also rub the sternum using your knuckles. This helps to ascertain whether the victim collapsed due to cardiac arrest, or there is another underlying reason. If there is no response, then cardiac arrest may be the reason for the collapse.

It would be best if you started CPR immediately once you have confirmed that the victim has collapsed because of cardiac arrest. Get someone else to call for the doctor as the sooner they arrive, the better.

Difference Between Heart Attack and Cardiac Arrest

A heart attack is caused when the artery or vein that takes blood to the heart is blocked. Cardiac arrest, on the other hand, is a result of a malfunction in the heart’s electrical system. Early signs of a heart attack may consist of:

❖Uneasiness in the chest. It may last for a few minutes, or it may disappear and come back later. It usually painful and may feel like squeezing in the chest, fullness or pressure.

❖Discomfort in the upper region of the body. The patient can experience discomfort in the arms, upper stomach, on the back and the jaw and neck regions.

❖Difficulty in breathing. This may occur simultaneously with the chest discomfort or in isolation.
❖The patient can also feel dizzy, nauseated, general body weakness and fatigue or lightheadedness.

Don’t Stop the Compressions When the Patient Gasps

Some people take gasping as an indicator to stop chest compression. This is not a standard procedure, and it is wrong. Gasping should be your confirmation sign that the victim had a cardiac arrest. It occurs a few minutes after cardiac arrest and may continue even after delivering chest compression CPR. It is not a sign of recovery but rather a sign that you are doing the right thing. It would help if you continued performing chest compression until the EMTs have arrived.

What to do if You Get Tired?

Performing chest compression is not an easy task and requires hard work. You can get tired after performing 100 chest compressions or less, and the best thing to do is to switch with another person. However, it would be best if you were mindful not to exceed the 10 seconds gap during the changeover.

Possible Damages When Doing CPR

Physicians and other medical professionals estimate that there is a 1% chance that a bystander could harm the victim by pressing very hard on their chest. The chances are slim compared to the possibility of death if the compressions are not performed. Furthermore, even if you are to break a rib or two during the process, they can be easily corrected, but it is impossible to correct death.

Checking for a Pulse

You can only check for a pulse if you are a trained medical doctor, a nurse or trained on CPR. Bystanders are not advised to check for a pulse because they might waste unnecessary time and also come up with a false conclusion. Besides, it is not advisable for public rescuers to check for a pulse because even if they do so promptly, there is a high chance that they will end up detecting their own pulse.

Checking the Airway

Checking the airway is only done if the victim or patient has collapsed due to choking. If this is not the case, then you should proceed with the 3Cs. The 3Cs entails checking for responsiveness, calling a medical person or EMTs and chest compression at the rate of 100 compressions per minute. Should also not worry is there is something in the airway as performing effective chest compression is likely to dislodge an object just like in Heimlich Maneuvers.

What to do if the victim has a Pacemaker or ICD

Neither a pacemaker or ICD should give you any problems. This is mainly because if the victim has an ICD and suffers a cardiac arrest, there is a high chance that it might not be functioning properly. Remember the ICD is used to prevent a cardiac arrest in the first place. Pacemakers are not similar to ICD in terms of functionality, but they should not give you any headaches. You should, therefore, continue to perform chest compression whether the victim has a pacemaker or ICD. It the compressions are not done within the first few seconds the victim can die.