You arrive on scene to find a pulseless 60-year-old man. What do you do first?

Starting compressions first is crucial in the case of a pulseless patient, as it helps circulate blood and maintain some level of perfusion to vital organs until advanced life support can be initiated. In the event of cardiac arrest, the immediate goal is to provide effective chest compressions, which significantly improve the chances of survival and neurological outcomes.

Chest compressions are essential because they help to manually pump blood throughout the body, ensuring that oxygen continues to reach the brain and other critical organs. This is particularly important in a pulseless individual, as the heart is not effectively circulating blood on its own.

While other options, such as using an AED or providing rescue breaths, are important components of advanced cardiac life support (ACLS), they cannot replace the immediate need for compressions. Performing high-quality compressions should take priority over other actions in the cardiac arrest algorithm, as time is critical, and each moment without adequate blood flow reduces the patient's chance of survival.

Inquiries about a Do Not Resuscitate (DNR) order, while important, should not delay the initiation of compressions if there is no clear indication of such an order being present at the time of arrival. Resuscitation efforts should commence promptly until the situation is assessed or