After 5 cycles of CPR (about 2 minutes), you pause briefly to check the person’s heart rhythm and look for signs of life. This pause should last no more than 10 seconds. If there are no signs of recovery, you immediately resume CPR for another 2 minutes and repeat the process until emergency medical services arrive or an AED becomes available.
That 2-minute checkpoint is one of the most important moments in CPR. What you do during those few seconds, and how quickly you get back to compressions, can determine whether the person survives.
The 10-Second Assessment Window
Every time you complete 5 cycles of 30 compressions and 2 breaths, you’ve used roughly 2 minutes. International resuscitation guidelines recommend pausing at this point to assess the person’s cardiac rhythm. If you have an AED, this is when the device will analyze the heart. If you don’t have one, you’re checking for any visible signs that circulation has returned.
The critical rule: keep this pause under 10 seconds. Each second without compressions causes blood pressure in the coronary arteries to drop, and it takes several compressions to build that pressure back up. A long pause essentially erases the progress your compressions have been generating. If you don’t clearly detect signs of life within 10 seconds, restart compressions immediately. When in doubt, keep pushing.
What to Look for During the Pause
During your brief check, you’re scanning for signs of spontaneous circulation returning. These include:
- Normal breathing: Not occasional gasps (which are common during cardiac arrest and don’t count), but regular, steady breaths that create visible chest rise.
- Movement: The person may begin to move, cough, or respond in some way.
- A pulse: If you’re trained to check, feel at the side of the neck for no more than 10 seconds. If you can’t clearly feel a strong pulse, assume there isn’t one and resume CPR.
If none of these signs appear, go straight back into compressions. Don’t second-guess yourself or extend the pause to “make sure.” The default action is always more CPR.
Using an AED at the 2-Minute Mark
If an AED arrives or becomes available during your CPR cycles, the 2-minute pause is the ideal time to use it. Turn the device on and follow its voice prompts. The AED will tell you to stop touching the person while it analyzes the heart rhythm.
If the AED recommends a shock, make sure no one is touching the person and press the shock button. Immediately after the shock, resume CPR. Don’t stop to check whether the shock worked. The AED will reassess the rhythm after your next 2-minute cycle. If the device says “no shock advised,” that also means resume CPR right away. A non-shockable rhythm does not mean the person has recovered.
Switch Rescuers Every 2 Minutes
If someone else is available to help, the 2-minute checkpoint is when you trade places. Research shows that compression quality starts declining after just 60 seconds, even though most rescuers don’t realize their pushes are getting shallower. By 90 seconds, compression depth is measurably reduced while the rate stays the same, meaning you feel like you’re doing fine but you’re actually delivering less effective CPR.
Coordinate the switch so it happens fast. The incoming rescuer should be positioned and ready before the pause begins. The goal is to lose no more than a few seconds during the handoff. If you’re the one stepping out, stay close. You’ll likely need to rotate back in after the next 2-minute cycle, and you want that brief rest to count.
If You’re Alone With No AED
When you’re the only rescuer and no AED is nearby, your job is simpler but more exhausting. Complete 5 cycles, do your quick check, and continue. If you’re performing hands-only CPR (compressions without rescue breaths), the same 2-minute rhythm applies. Push hard, push fast, pause briefly, and keep going.
For a lone rescuer helping a child, the protocol has one key difference. You should perform about 5 cycles (2 minutes) of CPR before leaving to call emergency services and grab an AED if one is nearby. This is because cardiac arrest in children is more often caused by breathing problems rather than a heart rhythm issue, so those initial 2 minutes of CPR with rescue breaths are especially valuable. After making the call, return and continue CPR immediately.
If the Person Starts Breathing Again
When you notice clear signs of recovery during a rhythm check, such as regular breathing, movement, or speech, you can stop compressions. But don’t walk away. The person is still in a fragile state and could go back into cardiac arrest at any moment.
If the person is breathing on their own but unconscious, place them in the recovery position to keep their airway open and prevent choking on fluid or vomit. Kneel beside them, extend the arm closest to you out at a right angle with the palm facing up. Fold their other arm so the back of that hand rests against the cheek nearest to you. Bend their far knee to a right angle, then gently roll them toward you by pulling on that bent knee. Their head should rest on their folded hand, and their bent leg and extended arm will keep them stable on their side. Tilt their head back slightly to open the airway.
Stay with them and monitor their breathing continuously until paramedics take over. If breathing stops again, roll them onto their back and restart CPR.
How Long to Keep Going
There is no set number of cycles where you should give up. You continue CPR until one of these things happens: emergency medical professionals arrive and take over, the person clearly recovers (breathing normally, moving, responsive), an AED becomes available and you begin using it, or you are physically unable to continue.
Fatigue is real and it sets in faster than most people expect. If no one is available to rotate with you, do your best to maintain compression depth of at least 2 inches and a rate of 100 to 120 pushes per minute. Even imperfect compressions are better than none. The 2-minute checkpoints give you a few seconds to catch your breath and reset your position before the next round.