A 13-year-old child witnesses a patient stop breathing and loses consciousness with no carotid pulse. Which action is MOST appropriate?

• A. Contact emergency medical services, then check airway
• B. Escort the child out of the room prior to initiating CPR
• C. Initiate CPR for 1 minute, then contact EMS if resuscitation is unsuccessful
• D. Instruct the child to contact emergency medical services, then initiate chest compressions

Answer: (D)

When someone stops breathing and has no pulse, the urgent goal is to restore circulation and get professional help on the way as quickly as possible. For a bystander, the most effective sequence is to call emergency services immediately and then start chest compressions. Activating EMS first ensures rapid arrival of advanced care, while beginning compressions right away maintains blood flow to the brain and heart. Delaying CPR to check the airway or to escort the child out of the room wastes precious seconds, and waiting a full minute before calling for help delays lifesaving support. So, guiding the child to contact EMS right away and then begin chest compressions is the best course. As soon as they start compressions, they should push hard and fast on the center of the chest (about 100–120 compressions per minute) and resume, adding breaths if trained.