Which signs indicate the return of spontaneous circulation (ROSC)?

The return of spontaneous circulation (ROSC) is indicated by certain physiological signs that suggest that the heart has resumed its normal pumping function and that blood is once again circulating through the body. Breathing, coughing, or movement are clear signs that the body is beginning to function semiautomatically, suggesting that the heart is effectively pumping blood and that the brain is receiving oxygenated blood.

Breathing indicates that the lungs are working, while coughing or movement implies an improvement in neurological function and responsiveness, as these reflexes generally require a degree of brain activity and an effective circulatory system.

Observing these signs means that the patient is likely moving out of a state of cardiac arrest and shows a positive clinical response that could lead healthcare providers to cease aggressive resuscitation efforts and transition to further monitoring and care. The presence of these signs is critical in determining the next steps in a resuscitation scenario.