Silly question about CPR

[mdiada]

I know the steps to CPR have changed -- compressions first, then give breaths. But we just had a test in my Med Surg class that had a particular question that, to paraphrase, said: "you come across an unresponsive person lying on the floor, what is the FIRST thing you should do?"

the answers were along the lines of:

1. shake the person and shout loudly

2. check for a pulse

3. check for breathing

4. i forget what this answer was

originally, the answer was "shake and shout," because of course, you have to check for responsiveness FIRST. but the phrasing of the question (i.e., "unresponsive") threw everyone off and we all figured that if you know someone is unresponsive, then surely you have already done the "shake and shout." needless to say, my teacher thankfully accepted another answer. but the answer she accepted was to check the pulse. the way i was taught just two months ago at the hospital i work at was that you ensure unresponsiveness, check for breathing, and then check for pulse. which one is it?

[Castiela]

In non hospital settings, they have taken out the "check for pulse" because the lay person would take too long to try and find one which takes time away from compression initiation.

Questions like this are hard because you do most of these checks at the same time. If I find a person down, I'm going to talking to them while finding a pulse and watching their chest... As we have more experience, a lot of this comes naturally without thinking. We just do

[Rocknurse, MSN, APRN, NP]

If you're following the AHA guidelines of BLS, the actual sequence is shake and shout FIRST, then call for help, then check for a pulse. The shake and shout is actually checking for responsiveness. The key is in the question when they ask "first". If you look at the actual CPR sequence it's always shake and shout first. They want to know that you're familiar with the algorithm.