A nurse finds an adult patient unresponsive in a hospital hallway. After confirming scene safety and calling for help, which assessment finding is the definitive indication to begin chest compressions immediately?
The patient is making agonal gasps.
The patient's skin is cool and cyanotic.
A carotid pulse cannot be definitively palpated within 10 seconds.
According to the American Heart Association (AHA) guidelines for healthcare providers, the definitive indication to initiate chest compressions is the absence of a palpable pulse after checking for no more than 10 seconds. Agonal gasps are considered a sign of cardiac arrest, not effective breathing. Cool, cyanotic skin and fixed, dilated pupils are also signs associated with cardiac arrest and poor perfusion, but the absence of a pulse is the primary assessment finding that triggers the start of chest compressions.
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