You should cease CPR only when the person you are helping shows clear signs of life and normal breathing, a more qualified medical professional takes over, or you become too exhausted to continue. Continuing CPR until one of these conditions is met is crucial for maximizing the chance of survival.
Understanding When to Stop CPR
Cardiopulmonary Resuscitation (CPR) is a life-saving technique used in emergencies when someone's breathing or heart stops. It's vital to continue CPR without interruption until specific criteria are met. Knowing these criteria ensures that care is provided for as long as necessary, but also that resources are managed appropriately.
The decision to cease CPR is based on three primary scenarios:
| Criterion | Description |
|---|---|
| 1. Signs of Life Return | The casualty begins to show clear signs of recovery, such as moving, moaning, coughing, or opening their eyes, and starts to breathe normally. |
| 2. Professional Handover | A more qualified medical professional, like a paramedic or doctor, arrives on the scene and takes over responsibility for the patient's care. |
| 3. Rescuer Exhaustion | You, as the rescuer, become physically unable to continue effective chest compressions or rescue breaths due to overwhelming fatigue. |
Detailed Explanation of Each Criterion
It's important to understand each point in detail to make an informed decision during a critical emergency.
1. Return of Spontaneous Circulation (ROSC) and Normal Breathing
This is the most desirable outcome. CPR should be stopped immediately if the person exhibits definite signs of recovery. This includes:
- Movement: The casualty starts moving their limbs or body voluntarily.
- Vocalization: They begin to moan, cry out, or make other sounds.
- Coughing: A clear, strong cough indicates a return of airway reflexes.
- Eye Opening: The person opens their eyes and shows awareness.
- Normal Breathing: Crucially, they must also start breathing normally. This is distinct from gasping, agonal breaths, or irregular shallow breaths, which are not considered normal and still warrant continued CPR.
If these signs appear, position the person in the recovery position (if appropriate and they are breathing normally) and continue to monitor their condition closely while awaiting further medical help.
2. Transfer of Care to More Qualified Personnel
CPR is often performed by a bystander before professional medical help arrives. Once trained emergency medical services (EMS) personnel, such as paramedics, emergency medical technicians (EMTs), or doctors, arrive on the scene, they will assume control. At this point, you should:
- Communicate Clearly: Inform them about what happened, how long CPR has been performed, and any other relevant observations.
- Relinquish Control: Allow them to take over the resuscitation efforts. They have specialized equipment, training, and protocols to continue advanced life support.
- Follow Instructions: Be prepared to assist if asked, but only under their direction.
3. Rescuer Exhaustion
Performing high-quality CPR is physically demanding, especially continuous chest compressions. If you are the sole rescuer and become too exhausted to continue effectively, your own safety and ability to perform adequate compressions become compromised. In such a scenario:
- Prioritize Safety: Your own well-being is important. If you can no longer deliver effective compressions, it's safer to cease.
- Team Approach: If multiple rescuers are present, it's recommended to rotate compressions every two minutes to prevent fatigue and maintain high-quality CPR. This ensures continuous, effective chest compressions without significant drops in quality.
It is important to remember that CPR should not be stopped unless one of these specific conditions is met. Until then, continue with uninterrupted, high-quality chest compressions and rescue breaths (if trained and willing), and if available, deploy an automated external defibrillator (AED) as soon as possible. The primary goal is to maintain blood flow to the brain and vital organs until professional help arrives or the person recovers.
