37.4. Which sign of cardiac arrest in casualties is considered in the basic algorithm of cardiopulmonary resuscitation:
UAЯка ознака зупинки серця у постраждалих враховується в базовому алгоритмі серцево-легеневої реанімації:
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This is an exam question from the first aid block, which in the driver training program supplements the traffic rules and is directly related to road safety. In practice, such knowledge is primarily needed by the driver after a traffic accident: the Traffic Rules of Ukraine require a participant in an incident to take possible measures to assist the victims and call an ambulance (clause 2.10 "g"), so the theoretical exam tests basic, easily understood by non-medics, signs of a critical condition.
The essence of the task is to understand the basic BLS (basic life support) algorithm: it relies on simple criteria that can be quickly and reliably assessed without medical training. That is why the key sign, which is used to decide to act immediately, is the absence of normal breathing after ensuring airway patency. Checking for breathing takes minimal time and gives the most practical hint that there is no time to delay: you need to call emergency services and start CPR.
Alternative answer options in this exam question may seem plausible, but are less suitable for the basic algorithm. Pupil dilation is not a reliable early sign and depends on many factors (lighting, trauma, medication), so it is not used as a key criterion for initiating action. Checking the pulse on the carotid arteries for an untrained person is often inaccurate under stress and takes time, so basic recommendations for bystanders focus on assessing breathing as the most understandable and quickest indicator of life-threatening danger.
Clause 2.10 (driver's duties in case of involvement in a traffic accident, subparagraph "g")
"take possible measures to provide pre-medical assistance to the victims, call for emergency medical assistance, and also report the incident to the authority or authorized unit of the National Police."
This clause of the Traffic Rules checks the general duty of the driver in case of an accident: to organize the provision of pre-medical assistance and to call emergency services. At the same time, the Traffic Rules of Ukraine do not contain medical criteria (signs) of cardiac arrest and do not describe the basic BLS/CPR algorithm (in particular, that in the basic assessment for starting CPR, the presence/absence of normal breathing is used as a guide) — this belongs to the educational section "Pre-medical assistance," and not to the text of the Traffic Rules.
Therefore, the correct answer is "Absence of breathing," given that according to the definition in the Traffic Rules, the driver is obliged to take possible measures to provide pre-medical assistance to victims and call an ambulance, and in the basic pre-medical assistance algorithm, the need for CPR is primarily determined by the absence of normal breathing.
In the basic algorithm of cardiopulmonary resuscitation (BLS), the driver or another witness of a traffic accident must act quickly and based on simple signs that can be reliably checked without medical training. That is why, in this algorithm, the key sign indicating a critical condition and the need for immediate resuscitation is the absence of normal breathing.
The logic here is practical: the body cannot survive without oxygen, and oxygen enters through the lungs. If a person is not breathing, oxygen stops entering the blood, and within a few minutes, the brain begins to suffer irreversible damage. Therefore, in BLS, breathing is assessed first and foremost: this is directly related to survival and allows you not to lose precious time.
An important point: in the basic algorithm, it is recommended to check for breathing, not to look for a pulse. For a non-medical person, it is often difficult to correctly determine the pulse: stress, noise, trembling hands interfere, as well as the risk of mistakenly "finding" one's own pulse or misinterpreting weak beats. Instead, the absence of breathing after ensuring airway patency (for example, tilting the head back and lifting the chin) is a clearer and more reliable sign for making a decision: to call emergency services and start CPR.
Imagine a situation on the road: the victim is lying unconscious, you have opened the airway, but the chest is not moving, there is no noticeable exhalation, no sound of breathing (or there are only rare, convulsive "gasps"). According to the basic algorithm, this means that breathing is absent or ineffective, and there is no time to delay — you must act as in the case of circulatory arrest.
Thus, the correct answer is "Absence of breathing," since in the basic CPR algorithm, the absence of normal breathing is the most reliable and quickest sign for a non-medical person of a critical condition that requires immediate resuscitation.