Which of the Following Would Indicate Cardiac Arrest? (Select 2 Answers)

The answer

Cardiac arrest is defined by two findings that you can check in seconds:

1. Unresponsiveness — the person does not react to tapping, shouting, or a shoulder squeeze.
2. No normal breathing — the person is not breathing at all, or is only gasping (agonal breathing).

When both are present, the heart has effectively stopped pumping blood. This is a clinical emergency: begin CPR immediately and get an AED.

Why the other options are wrong

The distractors in this question are usually chest pain, dizziness, headache, shortness of breath, or nausea. These can be serious, and several are classic heart-attack warning signs, but none of them defines cardiac arrest:

• A person having chest pain is, by definition, awake and able to feel and report it, so they are responsive and breathing. That is not arrest.
• Dizziness or a headache are symptoms a conscious person experiences. A cardiac-arrest victim is unconscious and cannot report anything.
• Shortness of breath means the person is still breathing. In arrest there is no effective breathing.

The test is trying to make sure you distinguish symptoms a conscious patient describes from the objective signs of a collapsed, non-breathing patient.

Cardiac arrest vs. heart attack

This is the single most important concept behind the question. A heart attack is a circulation problem: a blocked artery starves part of the heart muscle of blood. The person is usually awake, with chest pain, sweating, nausea, or arm/jaw discomfort. A heart attack can lead to cardiac arrest, but on its own it is not arrest.

Cardiac arrest is an electrical problem: the heart's rhythm fails and it stops pumping. The person collapses, goes unresponsive, and stops breathing normally within seconds. It is immediately life-threatening and requires CPR and defibrillation, not just calling for help.

Agonal breathing and the response sequence

Agonal breathing is the trap that fools many rescuers. It is a reflex, occasional gasping, snorting, or labored breaths in the first minutes after arrest. It is not effective breathing, and a victim showing only agonal gasps is in cardiac arrest and needs CPR. Never mistake gasping for normal breathing.

The correct action sequence is: check for response (tap and shout), call 911 and send for an AED, then check for breathing for no more than 10 seconds. If the person is unresponsive and not breathing normally, start chest compressions right away. Current lay-rescuer guidelines de-emphasize the pulse check because it is unreliable for untrained rescuers; unresponsive plus not breathing normally is enough to begin CPR.