What is the first action in the decision point for pulseless arrest?

• A. 2 minutes of CPR followed by rhythm check
• B. Defibrillate immediately
• C. Check pulse for 10 seconds
• D. Start IV access

Answer: (A)

In pulseless arrest, maintaining blood flow to the brain and heart is the immediate priority, so the first action is to start chest compressions right away and keep them going. You perform a couple of minutes of high‑quality CPR before pausing to check the heart rhythm. This sequencing ensures perfusion isn’t interrupted by an early rhythm check, giving the heart a better chance if a shock is later indicated. Defibrillation is then guided by what the rhythm check shows—only if the rhythm is shockable do you deliver a shock, and you resume CPR immediately afterward. While IV access and rapid rhythm assessment are helpful, they should not delay the essential compressions.