When Should You Not Perform CPR? A Guide to Life-Saving Decisions

CPR (Cardiopulmonary Resuscitation) saves lives, but there are specific circumstances where it may not be appropriate or effective. It is important to understand these limitations to make informed decisions and provide the best possible care. Knowing when should you not perform CPR is just as important as knowing when to do so.

If you understand the circumstances of not administering CPR, you can make informed decisions during emergencies. By recognizing these scenarios, you can ensure that you are offering appropriate and effective assistance in critical situations.

We’ll explore situations when CPR should not be performed and the signs to look for. There are a handful of circumstances in Nashville when CPR is not advised. If you’re unaware of them, you might end up harming someone or be in trouble for trying to help.

When Should You Not Perform CPR At All

While CPR can be highly effective in many situations, there are instances where it is not recommended or appropriate. Learn to distinguish the signs explained below.

Obvious Death

When encountering an unresponsive individual, assessing the situation and determining if CPR is appropriate is vital. When a person is dead and has been for a while, CPR has absolutely no impact. One of the key factors to consider is whether there are signs that death has set in. These signs may include:

    • Cold Skin: If the person’s body feels cold to the touch, it may indicate that death has occurred. The lack of blood flow and metabolic activity leads to a significant reduction in skin temperature.

    • Rigor Mortis: Rigor mortis is the stiffening of muscles after death. If the body is completely stiff and limbs do not move freely, it is a clear indication that CPR would not be effective.

    • Livor Mortis: Livor mortis, also known as postmortem lividity, refers to the discoloration of the skin due to pooled blood. Gravity causes purple or bluish spots to appear on the lower parts of the body. If lividity is present, it is a definitive sign of death.

Remember that it is essential to consider the context and surroundings when assessing these signs. For instance, low skin temperature may be misleading if the individual is exposed to cold temperatures or if you’ve come across a drowning victim. Additionally, injuries such as decapitation or severe obvious trauma may render CPR futile.

Recognizing Signs of Life

One of the primary reasons to stop CPR is the presence of signs of life. CPR is no longer needed if the individual shows clear signs of consciousness or responsiveness. These signs of life may include:

    • Purposeful Movement: If the person starts moving their limbs, head, or face intentionally, it indicates that they are conscious and no longer require CPR.

    • Making Sounds: Sometimes, an unconscious person may start making sounds, such as moaning or speaking. This positive sign of responsiveness suggests that CPR can be discontinued.

    • Eye Movement: If the unresponsive person starts moving their eyes, blinking, or focusing their gaze on specific objects, it signifies a return of consciousness.

    • Unassisted Breathing: While performing CPR, when you notice that a person has re-started breathing on their own, you should stop administering compressions and mouth-to-mouth breaths. Breathing means that the heart is pumping as well, so proceeding with CPR might turn into a damaging decision.

It is important to note that these signs of life may be rare in out-of-hospital settings. However, if you observe any of these positive indicators, it is appropriate to seize your CPR efforts. If the person becomes unresponsive again, resume CPR immediately.

An Unsafe Scene

There are some instances, however rare, when performing CPR may not be possible due to safety concerns. Rescuers should always prioritize their own safety and the safety of others. If the scene is hazardous or poses a risk to the rescuer, you must turn to professional assistance, waiting for trained emergency medical services or relevant authorities.

In such a scenario, you should promptly call for help and remain at a safe distance. This is particularly important in cases involving ongoing violence, the threat of electrocution, the presence of wild animals, or other serious threats of any kind. It is essential to ensure the safety of both yourself and the victim before initiating any life-saving interventions.

Age Considerations

When considering whether to perform CPR, age can be a significant factor to take into account.

CPR techniques differ from those used on adults, infants, and young children. It is crucial to receive proper training in pediatric CPR to ensure the best possible outcomes in emergency situations involving children. If you lack this training, you should not be administering CPR, as you’ll likely worsen the situation.

When Should You Stop Performing CPR

Now that we have covered the key instances that define when you should not perform CPR, let’s look at a few situations when, upon noticing certain signs, you should stop performing CPR and reassess the situation.

Ethical Aspects of Withholding CPR

The decision to withhold CPR can raise ethical dilemmas for healthcare providers and individuals in emergency situations. It is crucial to balance the duty to preserve life with respect for individual autonomy and the quality of life.

An example where CPR may not be recommended is when a do-not-resuscitate (DNR) order is in place. A DNR order is a legal document indicating a person’s wish to forgo life-saving measures in the event of cardiac arrest or other critical situations. People with a DNR wear a bracelet or have clearly visible tattoos depicting their wishes. You must respect and follow these orders, as honoring the victim’s wishes takes precedence over administering CPR.

Arrival of Advanced Help

When emergency medical services (EMS) personnel arrive at the scene, leave the care of the individual to them. EMS professionals have advanced medical expertise and resources, including defibrillators and specialized training. Clear communication and cooperation with EMS personnel are crucial for the seamless transfer of care.

During the transition, it is essential to provide accurate information about the duration of CPR and any changes in the person’s condition. EMS staff will assess the individual’s vital signs, responsiveness, and overall condition and make decisions accordingly. Once advanced help arrives, stopping CPR and following their directions is appropriate.

Physical Fatigue: Know Your Limits

If you’ve never performed CPR in an actual situation, know that doing so can be very physically demanding and exhausting, especially when attempting to revive someone for an extended period. While CPR improves brain function in survivors, it is important to be aware of your limitations. Fatigue can compromise the effectiveness of CPR and potentially put you at risk as well.

Studies have shown that CPR may take 30 minutes to 1.5 hours before a person responds. Maintaining high-quality chest compressions and rescue breaths during this time is crucial. However, if you start feeling physically exhausted and unable to continue performing CPR, it is appropriate to stop. Fatigue is a valid reason to discontinue CPR, as it is protected under Good Samaritan laws in most states.


Knowing when not to perform CPR is just as important as knowing when to initiate this life-saving technique. Considering the signs of apparent death, physical fatigue, signs of life, arrival of advanced help, and the safety of the rescuer and victim are all crucial factors in making informed decisions about CPR.

Remember, the decision to stop CPR should be made with careful consideration of the specific circumstances and in consultation with trained medical professionals. When should you not perform CPR is an important aspect of CPR training which we cover in-depth in our CPR certification courses, so if you’re a Nashville resident, sign up today and extend your knowledge!