A cardiac arrest is the most extreme emergency and happens when the heart stops beating in a normal way. Knowing how you can help could save a life.
For someone in cardiac arrest they will die within minutes unless treated immediately with cardiopulmonary resuscitation (CPR). You can be performing CPR whilst waiting for the ambulance to arrive.
If you come across someone in cardiac arrest, just think DRS ABC:
- Danger – keep calm and check the scene is safe to approach
- Response – shout “are you alright?” and shake the person’s shoulders
- Shout for help– send someone for help and call 999
- Airway – tilt the head back gently to open the airway
- Breathing – check for normal breathing by looking at the chest to see if it is rising and falling or listening for abnormal sounds such as infrequent and noisy gasps
- Compressions – if the patient is not breathing normally, start hands only CPR pushing hard and fast in the centre of the chest.
If there is an automated external defibrillator (AED) nearby send someone to get it. You do not need prior knowledge of how to use one as it will give clear instructions. It could save someone’s life.
To carry out a chest compression:
- Kneel next to the person and place the heel of your hand in the centre of their chest. Place the palm of your other hand on top of the hand that’s on their chest and interlock your fingers.
- Position yourself so your shoulders are directly above your hands.
- Using your body weight (not just your arms), press straight down by five to 6 centimetres (two to two and a half inches) on their chest, approximately a third of the depth of the patient’s chest.
- Keeping your hands on their chest, release the compression and allow their chest to return to its original position.
- Repeat these compressions at a rate of 100 to 120 times a minute (approx. two per second) until an ambulance arrives or for as long as you can, if someone else is with you ask if they can swap with you.
You should carry out CPR with five rescue breaths on a child. It’s more likely children will have a problem with their airways and breathing than a problem with their heart.
- Open the child’s airway by placing one hand on their forehead and gently tilting their head back and lifting the chin. Remove any visible obstructions from their mouth and nose.
- Pinch the child’s nose. Seal your mouth over their mouth, and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths.
- Place the heel of one hand on the centre of the child’s chest and push down by five centimetres (about two inches), which is approximately one-third of the chest depth. The quality (depth) of chest compressions is very important. Use two hands if you can’t achieve a depth of five centimetres using one hand.
- After every 30 chest compressions at a rate of 100 to 120 a minute (two per second), give two breaths.
- Continue with cycles of 30 chest compressions and two rescue breaths until the child begins to recover or emergency help arrives.
- Open the infant’s airway by placing one hand on their forehead and gently tilting the head back and lifting their chin placing them in a neutral position, you may need to place something under their shoulders to maintain this position. Remove any visible obstructions from their mouth and nose.
- Place your mouth over the infant’s mouth and nose and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths.
- Place two fingers in the middle of the infant’s chest and push down by four centimetres (about one and a half inches), which is approximately one-third of the chest depth. The quality (depth) of chest compressions is very important. Use the heel of one hand if you can’t achieve a depth of four centimetres using the tips of two fingers.
- After 30 chest compressions at a rate of 100 to 120 a minute (two per second), give two rescue breaths.
- Continue with cycles of 30 chest compressions and two rescue breaths until the infant begins to recover or emergency help arrives.
- In children and infants with cardiac arrest, a lone rescuer should immediately start CPR as described above. In cases where the likelihood of a primary shockable rhythm is extremely high, such as in sudden witnessed collapse, if easily accessible, the rescuer should apply an AED (at the time of calling emergency services – Ambulance). When there is more than one rescuer, a second rescuer will immediately call for help and then collect and apply an AED (if feasible).
- If possible, use an AED with a paediatric attenuator (normally a switch on the device or separate pads specific to use on children in infants and children below eight years old. If this is not available, use the standard AED (for all ages).
- Defibrillators can be used on any aged person, follow the instructions given and visible.
- Ensure safety when using and make sure the patient is in a safe area prior to any shocks being delivered.
What are the first steps I should take?
Here are the steps you need to take to do CPR:
Before you approach the person, who has collapsed, check your surroundings for danger.
1. Shout for help:
- shake them gently.
2. Look and listen for signs of normal breathing:
- look for the rise and fall of their chest.
3. Call 999:
- put the phone on loudspeaker and tell them you are with someone who is not breathing.
4. Fetch an AED if there is someone else present:
- the ambulance call handler will tell you where the nearest AED is. If someone is with you, ask them to fetch it and bring it back. Do not leave the person if you are on your own.
5. Start chest compressions:
- interlock your fingers.
- place your hands in the centre of the chest.
- push down hard and then release twice per second, and don’t stop. The ambulance call handler will help you.
6. Continue CPR until:
- the AED asks you to pause while it reanalyses and gives another shock if needed.
- a paramedic arrives and tells you what to do.
- the person shows signs of life.