An unresponsive 56 year old male has no chest rise. You are unable to palpate a carotid pulse. You should next:

• A. Start chest compressions
• B. Check for a radial pulse
• C. Auscultate (listen) for heart sounds
• D. Check the other carotid pulse

Answer: (A)

Begin chest compressions immediately. In an unresponsive adult who is not breathing normally and in whom you cannot palpate a carotid pulse, treat this as cardiac arrest and start CPR without delay. Time matters because perfusion to the brain and heart drops quickly without circulation. Spinning through additional pulse checks or listening for heart sounds would waste precious seconds and won’t change the outcome here. Deliver high‑quality chest compressions—about 100 to 120 per minute with a depth of at least 2 inches (5 cm) for adults, allowing full recoil between compressions. If possible, call for help and get an AED on scene as soon as you start, continuing CPR until professional help arrives or the patient shows signs of life.