You and another lifeguard find an unresponsive adult on the locker room floor. The other lifeguard goes to summon EMS personnel. You form an initial impression, complete a primary assessment and find that the victim has a pulse but is not breathing. Which of the following should you do next?
Give back blows and chest thrusts.
Give ventilations at a rate of 1 about every 5-6 seconds.
Perform CPR.
Perform a finger sweep of the victim’s mouth.
The Correct Answer and Explanation is:
Correct Answer: Give ventilations at a rate of 1 about every 5–6 seconds.
Explanation
When encountering an unresponsive adult who has a pulse but is not breathing, the appropriate next step is to provide rescue breathing, also known as ventilations. This means you should give 1 ventilation (breath) every 5–6 seconds, or about 10–12 breaths per minute. This is in accordance with American Red Cross and American Heart Association guidelines for adults in respiratory arrest (not breathing but with a pulse).
The goal of rescue breathing is to supply oxygen to the lungs and vital organs until the person can breathe independently or until advanced medical personnel arrive. Since the heart is still circulating blood (as indicated by the presence of a pulse), there is no need to perform chest compressions or full CPR unless the pulse is lost.
Let’s briefly address why the other options are incorrect:
- Back blows and chest thrusts: These are used for a conscious adult who is choking and cannot cough, speak, or breathe due to an obstructed airway. In this case, the victim is unresponsive, and there is no mention of choking or a blocked airway.
- Perform CPR: CPR, which includes chest compressions, is only necessary when the victim has no pulse and is not breathing. Performing compressions on someone with a pulse can cause harm.
- Finger sweep of the victim’s mouth: A finger sweep is only recommended if you see a visible object in the mouth that can be removed easily. Blind sweeps can push an object deeper into the airway and cause more harm.
Therefore, the most appropriate and lifesaving action in this situation is to initiate rescue breathing at the correct rate and continue monitoring the victim’s pulse and breathing status until EMS personnel take over.
