In this blog, we talk you through the basic steps of what to do if someone has suffered a cardiac arrest, whether you’re at home, work or any other public place. It’s a good idea to familiarise yourself with these steps so that if you ever find yourself in a position where you need to act when someone has collapsed, you will be able to do so as quickly as you can.
You may have heard of the acronym DRS ABCD used with regard to responding to a cardiac emergency. It’s a basic structure which outlines each step of the rescue process, and it’s easy to remember. Let’s look at what it means:
D - Danger.
First things first, you should never put yourself in any danger when trying to help someone else. You are the most important person in a medical emergency, and you can’t help anyone if you put yourself at risk and end up injured in the process. Evaluate your environment to determine if there are any immediate dangers posed to you, or the casualty. This could be anything from live electrics that could cause electrocution, falling debris, traffic or fire.
It’s important to say here that you should not necessarily be concerned with contracting coronavirus by helping someone in a medical emergency. If you don’t know the casualty, you may be reluctant to get too close to them, but guidance from the Resuscitation Council UK says that unless you are a vulnerable person, you should not be concerned with contracting coronavirus. The likelihood of catching coronavirus is minimal, and is offset by the fact that the casualty will die without immediate treatment. You should wear a mask and gloves throughout the process if you can, and you should not put your face close to theirs to check for breathing. We can’t stress enough how important it is to help if you can, but ultimately, it’s your decision if you feel comfortable enough to step in and potentially save a life.
R - Response.
If someone has collapsed and appears to have had a cardiac arrest, the first thing to check for (after you have established you are not in any danger of course) is to check for a response from the casualty. Call out to them, use their name if you know it, and ask if they can hear you.
You can gently shake them by the shoulders to try and gauge a response, but don’t do so too forcefully, especially if you don’t know if they may have any other injuries that aren’t apparent from first glance. If there is no sign of life from the casualty, they will require immediate medical attention.
S - Send for help.
By this point, you should call 999, and summon somebody to help you if you can. If you are able to get someone to help you, they can continue to follow these steps while you are on the phone to the emergency services, or vice versa. If you suspect the casualty could have COVID, make sure you inform the ambulance dispatcher on the phone when you call them.
A - Airways.
The casualty may have choked on something, or they could be at risk of airway obstruction due to the back of the tongue falling back while they are unconscious. You need to open the airway by performing a head tilt chin lift demonstrated by the photo above.
B - Breathing.
As stated earlier, it is not advised to put your face close to the casualty’s to check for breathing, so you should instead watch for the rise and fall of the chest, to see if there is any movement there. If there is a perceived risk of infection, rescuers should place a cloth/towel over the victims mouth/nose and attempt compression only CPR and early defibrillation until the ambulance (or advanced care team) arrives. At this point, send someone to fetch the nearest defibrillator - the 999 call handler should be able to advise you on its exact location.
C - CPR.
Put hands together in the middle of the chest and push hard and fast. Chest compressions should be started as soon as possible at a rate of 100 – 120 per minute. You might find it beneficial to give compressions in time to the beat of popular songs; some of these you have most likely heard of, including ‘Stayin’ Alive’ by The Bee Gees, 'Dancing Queen’ by ABBA or ‘Nellie the Elephant’.
D - Defibrillation.
Once an Automated External Defibrillator (AED) arrives it should be used as soon as possible. Most defibrillators are in a case or sleeve with the pads stored alongside them, some you just need to open up and switch straight on, which are even easier to use if the pads are already pre-connected.
When the defibrillator turns on, it will give clear voice prompts, and some AED’s give visual instructions via a screen (depending on the make and model). The instructions are very clear and easy to follow, regardless of whether the defibrillator is fully or semi automatic. The defibrillator will talk you through every step, even down to opening the pad packaging and applying them to the patients’ chest - there’s usually an image to show you the correct placement as a guide. The device will instruct you to commence chest compressions once you have applied the pads, and will then analyse the heart rhythm, to determine whether or not a shock is advised. If the defibrillator is semi automatic, the ‘shock’ button will usually illuminate when the voice prompts tell you the button needs to be pressed to deliver a shock.
Early use of a defibrillator significantly increases the person’s chances of survival and does not increase risk of COVID infection. Continue to follow the instructions of the defibrillator until the ambulance arrives or until you tire - if possible, get someone else to take over the chest compressions. Good, quality chest compressions are very taxing and can cause you to become exhausted.
When the ambulance arrives, they will take over treatment of the patient. When you can, you should wash your hands thoroughly with soap and water; alternatively, use an alcohol-based hand gel if you are unable to access soap and water. You should also seek further advice from the NHS 111 coronavirus advice service.
A defibrillator should always be used where possible, as it can make a huge difference when it comes to treating someone who has a cardiac arrest. Browse our range of defibrillators so your school, place of work or community is heart safe.