Possessing the knowledge to perform CPR can potentially save a life. However, there are instances and situations where CPR is either no longer viable or not needed at all. Some of the signs to stop performing CPR may seem obvious, but when found in an emergency, things tend to be different.
Even if you have some form of CPR training, knowing when to stop performing CPR is equally important to know. Read on to learn why and when it is time to stop performing CPR.
5 Signs and Situations to Stop Performing CPR
There are rules and signs to know and spot when CPR is needed. There are also rules and signs to know when to stop performing CPR. We identified 5 signs and situations you need to be aware of:
- Signs of Life
- Medical Intervention
- DNR order
- Death of Victim
- Unsafe Scene
Signs of Life
When performing CPR, look out for clear signs of life. If the person starts showing any kind of consciousness, including breathing, moving their body, opening their eyes, or making sounds and talking, it’s time to stop the chest compressions. Checking for a pulse should be your priority.
If you feel any pulse or notice normal cardiac rhythm, there is no need to continue CPR. Now, if the person becomes conscious, it is wise to get their attention and keep them calm and comfortable as much as possible until paramedics get to the scene.
If you are performing CPR, and paramedics and EMTs arrive at the scene, it isn’t a cue for you to stop what you are doing. They need to assess the situation and get the equipment ready. Once they tell you to stop, move away and let the professionals take over.
EMTs and paramedics will ensure a return of spontaneous circulation (ROSC). Using chest compressions or an automated external defibrillator, paramedics will look for any signs of life. By watching the breathing to detect ROSC, paramedics may intervene by placing an ETT (endotracheal tube). It means taking over the person’s breathing by performing RSI (rapid sequence intubation).
Paramedics will look for an increase in End Tidal CO2, using an EtCO2 monitor showing them the amount of carbon dioxide exhaled. By this point, CPR is no longer needed, and the paramedics should transport the person to the hospital for further tests.
CPR is the first thing that comes to mind when you are a random bystander and a person nearby is having a cardiac arrest. However, before proceeding, check for a DNR order bracelet or DNR order wallet card.
A do-not-resuscitate (DNR) order is one of many advanced directives that a person can request from their physician. A DNR means they do not want cardiopulmonary resuscitation (CPR) performed if their heart stops or they stop breathing. Often, people requesting a do-not-resuscitate (DNR) order have either a terminal illness or a serious medical condition.
In every state in the US, DNR orders are accepted by every doctor and hospital. When a person has gained insight into the positives and negatives of CPR, the doctor will place the DNR order in their medical record. What does this mean? If you have any medical emergency where your heart stops or you stop breathing and are not able to make a conscious decision, your family, paramedics, and doctors aren’t allowed to perform CPR.
In some states, there are two types of do-not-resuscitate DNR orders:
- DNR comfort care – it allows paramedics and doctors to only administer comfort care before, during, and after the person’s heart stops or they stop breathing.
- DNR comfort care-arrest – it allows paramedics and doctors to use any life-saving method only before the person’s heart stops or they stop breathing.
Death of Victim
CPR is used for victims of cardiac arrest; if death is apparent, you should stop performing CPR. To be certain that CPR is useless, you should know the several stages of death.
Touch the victim to see whether they are cold to the touch. A cold body, in most cases, means the person is far beyond the point of receiving CPR. However, there are cases when the surroundings should be taken into consideration. Weigh the surrounding factors like a particularly cold environment or drowning victim, which may provide false information.
Be sure to check and rule out all possibilities that point to the certain death of the victim before deciding not to administer CPR. Unless the body is in rigor mortis, performing CPR is advisable.
You can recognize whether the person has been dead for hours by the stiffness of their limbs. Rigor mortis can occur as soon as 4 hours after the person dies, and both arms and legs won’t freely move. If you find a person completely stiff, they will be way beyond the point of getting CPR.
Livor Mortis, known as postmortem lividity, is a sign of death that occurs hours after a person has died. The bluish skin is a result of the blood accumulating in the blood vessels as a result of gravity.
It does resemble bruising, but there are differences. Livor mortis occurs at the center of gravity. You may spot the bluish skin on their face or front torso if the person is lying face down.
Major Traumatic Injuries
Many emergency medical services have protocols to not even attempt CPR if the person has suffered major traumatic injuries. For example, if a major traumatic injury has occurred, like an amputation, the loss of blood will be massive.
If you ever find yourself in a situation where the scene to perform CPR is unsafe, try moving the person to a safer place. However, if moving the person isn’t an option or the scene is too dangerous, you should always consider your safety and health first.
For example, If the victim has been electrocuted, is in a body of water, or there is a high volume of moving traffic, it is better to keep yourself safe and proceed to call 911.
Key Takeaways: When to Stop Performing CPR
When you witness a person having a cardiac arrest, it is important to assess every aspect of the situation. Start off by checking for a DNR order bracelet or card to know whether you can actually even start CPR. If the person goes unconscious, look for signs of life that include breathing or a steady pulse. If they aren’t present and you have to do CPR for longer than 20 minutes, the person isn’t likely to survive.
And although you may need to follow certain legal considerations and ethical considerations, helping a person comes on top. Follow all the steps and keep calm and composed until medical teams arrive.
How long should I perform CPR before stopping?
Some say that performing CPR for over 20 minutes doesn’t provide any results, and it should be stopped. However, recent studies document that patients who receive 30+ minutes of CPR have a higher chance of survival.
Do you stop CPR when an AED becomes available?
Perform CPR until the AED device is ready for use. AED is used in combination with CPR, meaning each shock is followed by chest compressions. Newer AEDs indicate whether the person needs more CPR or shocks after it has been used.
How to require a DNR order?
Your primary physician presents the pros and cons that can come with CRP, and you will decide whether you want a DNR order. After you confirm with your doctor, they can place the DNR order in your medical records.
Do I call 911 before or after performing CPR?
Calling medical professionals should be the number one priority. Assess the situation and call 911 for assistance. If there are other bystanders near you, ask them to call 911 while you attend to the victim. If the person is conscious, keep calm, and talk to the victim to see what you can do to help them. However, if the person is unresponsive and doesn’t show any signs of life, proceed to perform CPR.