When is it appropriate to begin CPR if you do not feel a pulse in a child?

Beginning cardiopulmonary resuscitation (CPR) promptly is crucial when there is no detectable pulse in a child. The recommendation to initiate CPR within 10 seconds of identifying the absence of a pulse is based on the need to act swiftly to prevent irreversible brain and organ damage that can occur due to lack of blood flow and oxygen.

In pediatric emergencies, every second matters. If a pulse cannot be felt, it’s essential to quickly check other signs of circulation, like respiration, but if those signs are also absent or if the child is unresponsive, starting CPR immediately is vital. Thus, initiating abdominal compressions and ventilations without delay is the most effective course of action to sustain life until emergency services arrive.

The other options do not emphasize the urgency needed in this scenario. Checking for breathing before starting CPR may cause delays that can be harmful, and assessing for signs of shock could also prolong the response time. Waiting until reaching the emergency room is not appropriate, as immediate action is essential outside of a hospital setting where resuscitative efforts can begin right away.