In a pulseless, unresponsive patient, which action should you perform first?

• A. Open airway
• B. Begin chest compressions
• C. Attach AED
• D. Ventilate

Answer: (B)

When a patient is pulseless and unresponsive, the immediate goal is to restore circulation by starting chest compressions right away. Perfusing the brain and heart beats priority because every moment without blood flow increases the chance of permanent injury. While compressions are ongoing, call for help and get the AED ready; attach it as soon as it’s available and follow its prompts. Airway management and ventilations are important, but delaying compressions to open the airway would waste precious seconds of perfusion. If you’re trained and able, you can provide ventilations after starting compressions, but the first action must be to begin chest compressions.