Version control: This document is current with respect to the latest 2016 American Heart Association® Guidelines for CPR and ECC. These guidelines are current until they are replaced on October 2020. If you are reading this page after October 2020, please contact ACLS Training Center at for an updated document.

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The main focus of the BLS Primary Survey (see Figure 1) is early CPR and early defibrillation, if needed. For a patient in respiratory arrest, however, the focus is on breathing and airway issues. The process starts with assessing the patient and then perform an appropriate action. Each step in the survey has an assessment and actions to follow.

Figure 1. Basic Life Support Decision Tree

Assessment Action

Is the patient breathing?

Look for the rise and fall of the patient's chest.

Does the patient have a pulse?

The healthcare provider can take 5–10 seconds to check for a pulse.


When the AED arrives, place it on the patient and follow the prompts

Is the patient breathing NORMALLY? (small gasping breaths are not considered normal.

If no pulse – BEGIN COMPRESSIONS at a rate of 100/min to 120/min

If not sure if a pulse is present, BEGIN COMPRESSIONS at a rate of 100/min to 120/min

If pulse is present and breathing absent, begin ventilation at a rate of 10 per minute or once every 6 seconds using mouth to mouth or bag valve mask.

The last step, defibrillation, is part of the primary survey, but is not required for respiratory arrest as the patient has a pulse for this case. Therefore the AED will advise the user "no shock advised, continue CPR if necessary."