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Return of Spontaneous Circulation (ROSC)

Return of Spontaneous Circulation (ROSC) Pronunciation: R-O-S-C (ār-ō-ēs-sē)

Definition: Return of Spontaneous Circulation (ROSC) refers to the restoration of a pulse and effective blood flow to the body following cardiac arrest. ROSC is typically achieved through cardiopulmonary resuscitation (CPR) and defibrillation and is considered a crucial goal in resuscitation efforts.

What is Return of Spontaneous Circulation (ROSC)?


ROSC is a term used to denote the point at which palpable pulses return and effective blood circulation is restored to the body after cardiac arrest. This event is the initial goal of CPR and advanced cardiac life support (ACLS). Achieving ROSC often signifies that the immediate life-threatening condition has been temporarily resolved, but post-resuscitation care is crucial to maintain circulation and prevent another cardiac arrest.

Key Facts about Return of Spontaneous Circulation (ROSC):

  • ROSC is the primary goal of CPR and other resuscitation efforts. It indicates that the patient’s heart has resumed pumping blood.
  • The occurrence of ROSC can be identified by the return of a pulse, a rise in blood pressure, or a sudden increase in end-tidal CO2 (the concentration of carbon dioxide in exhaled air).
  • Even after achieving ROSC, the patient is still at risk of re-arrest. Continuous monitoring and post-resuscitation care are essential.
  • Factors such as the duration of cardiac arrest, the initial heart rhythm, and the quality of CPR can influence the likelihood of achieving ROSC.

Achieving and Maintaining ROSC

How to achieve and maintain ROSC?

Achieving and maintaining ROSC requires effective resuscitation efforts and post-resuscitation care:

  • Perform high-quality CPR: Provide chest compressions of adequate rate and depth, allow for full chest recoil, minimize interruptions in compressions, and provide effective breaths.
  • Use an Automated External Defibrillator (AED) if the cardiac arrest is due to a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia).
  • Once ROSC is achieved, post-resuscitation care should be initiated immediately to stabilize the patient and prevent recurrence of cardiac arrest.

Frequently Asked Questions About ROSC

What does it mean when ROSC is achieved?

Achieving ROSC means that the heart has started to effectively pump blood again after a period of cardiac arrest. This is a critical step in resuscitation and improving survival rates.

How is ROSC determined?

ROSC is determined by the return of a pulse or other signs of circulation such as a rise in blood pressure or an increase in end-tidal CO2.


  1. American Heart Association. (n.d.). Part 7: Adult Advanced Cardiovascular Life Support. Retrieved July 26, 2023, from
  2. Mayo Clinic. (2023). Cardiopulmonary resuscitation (CPR): First aid. Retrieved July 26, 2023, from