One of the most debated questions in emergency care—especially among new providers—is whether you should begin CPR without checking for a pulse. The answer isn’t just about following protocol; it’s about saving lives in the critical first minutes of cardiac arrest. Let’s break it down.
Current Guidelines: What Do They Say?
According to the American Heart Association (AHA) guidelines:
- Lay responders (bystanders) are not required to check a pulse.
- Healthcare providers are advised to check a pulse, but only for no more than 10 seconds.
If no pulse is found—or if you’re unsure—start CPR immediately.
Why Skip the Pulse Check as a Bystander?
For laypeople, checking a pulse can waste precious time and may be inaccurate. Studies show that untrained responders often:
- Take too long trying to locate a pulse.
- Miss a weak or slow pulse altogether.
- Delay starting chest compressions, which reduces survival chances.
This is why hands-only CPR (compressions only, no breaths) is recommended for untrained bystanders.
What If You’re a Trained Healthcare Provider?
If you’re trained and experienced, a quick pulse check (≤10 seconds) is appropriate. But even then:
- If there’s any doubt or you can’t confidently feel a pulse, start compressions.
- It’s better to give CPR unnecessarily than to wait too long.
Can CPR Hurt Someone With a Pulse?
Yes—but usually, minor injuries like broken ribs. The risk of harm is low compared to the risk of death from cardiac arrest. If someone is unconscious and not breathing normally, the benefit of starting CPR far outweighs the risk.
Bottom Line: Don’t Wait, Just Act
If you’re unsure and the person is:
- Unresponsive
- Not breathing normally
Don’t waste time. Start CPR. Let the AED and emergency professionals take it from there.
