A passenger loses consciousness and has no pulse. Immediate steps?

• A. Call for help, then check blood sugar
• B. Give oxygen only
• C. Wait for EMS
• D. Begin CPR with chest compressions and apply AED

Answer: (D)

When someone is unconscious with no pulse, the priority is to restore circulation as quickly as possible. The immediate action is to start high-quality CPR to keep blood flowing to the brain and heart while you arrange for a defibrillator. Deliver chest compressions hard and fast, about 100–120 compressions per minute, and compress deeply enough (around 2 inches or 5 cm for adults) with complete chest recoil between pushes. Do not pause too long to check blood sugar or perform other checks; these can waste precious time and delay airflow and circulation. Oxygen therapy alone cannot restart a stopped heart, so waiting for EMS or delaying CPR won’t bring the patient back as effectively as starting compressions right away.

Bring in an AED as soon as it’s available. Turn it on, place the pads as indicated, and let the device analyze the rhythm. Keep everyone clear of the patient during analysis and shock delivery, then resume CPR immediately after the shock is delivered or if no shock is advised, continuing in a cycle of 30 compressions to 2 breaths (if trained to provide breaths) until EMS arrives or the person regains signs of life. In this setting, acting now with CPR and AED use offers the best chance of survival.