An unresponsive 63-year-old female in cardiac arrest after an opioid overdose needs immediate attention. What should you do first?

Initiating chest compressions is the most critical first action when dealing with a cardiac arrest, particularly in the context of an opioid overdose. Cardiac arrest is an emergency situation where circulation has ceased, meaning the heart is not effectively pumping blood to the body, particularly the brain and vital organs.

When a patient is in cardiac arrest, high-quality chest compressions serve to maintain some level of blood flow, even if it is not perfect. This is essential to prevent further brain damage and increase the likelihood of a successful outcome when advanced cardiac life support measures are applied.

In cases of opioid overdose, while administering naloxone is important for reversing the effects of opioids, the overriding priority in an unresponsive patient who is in cardiac arrest is to provide immediate chest compressions. Rescuing circulation takes precedence in the acute management of cardiac arrest to buy time until other interventions, such as the administration of naloxone, can be performed effectively.

This approach aligns with the current guidelines for cardiopulmonary resuscitation (CPR), which recommend starting compressions immediately without delay. When you commence chest compressions, you create a foundation for further lifesaving actions, which may include defibrillation and the use of opioid antagonists like