Sudden cardiac arrest does not always come with a warning. A person may be talking, laughing, working, or eating dinner, and then suddenly collapse. Not planned, and never convenient.

They may not respond when you tap their shoulder and shout. They may not be breathing normally. Sometimes they may only gasp, which can be confusing because it looks like breathing, but it is not normal breathing.

That is the moment when quick action matters.

Many cardiac arrests outside the hospital happen at home. That means the person who needs help may be someone you know: a spouse, parent, grandparent, friend, coworker, or neighbor. The first few minutes are critical. Starting CPR right away can help keep blood moving to the brain and vital organs until emergency responders arrive.

What is sudden cardiac arrest?

Sudden cardiac arrest happens when the heart suddenly stops pumping blood the way it should. In many cases, it is caused by a problem with the heart’s electrical system. Instead of beating normally, the heart may quiver or fall into a dangerous rhythm. Blood stops moving through the body, and the person quickly becomes unconscious.

Cardiac arrest is not the same as a heart attack.

A heart attack is usually a circulation problem. Blood flow to part of the heart muscle is blocked. The person may still be awake and may complain of chest pressure, shortness of breath, sweating, nausea, or pain in the arm, jaw, back, or stomach.

Cardiac arrest is different. The person is usually unresponsive and not breathing normally. They need CPR right away, and an AED if one is nearby.

Signs someone may need CPR

Start CPR if the person:

• Suddenly collapses
• Does not respond when you tap and shout
• Is not breathing normally
• Is only gasping

Gasping can happen during cardiac arrest. Do not wait around hoping it turns into normal breathing. If the person is unresponsive and not breathing normally, start CPR.

Hands-Only CPR steps for adults

Call 911 immediately.
Put the phone on speaker if you can. This lets you talk with the dispatcher while keeping your hands free.

Send someone for an AED.
If other people are nearby, be direct. Point to one person and say, “You, get the AED.” A clear instruction works better than a general shout into the room.

Start chest compressions.
Place the heel of one hand in the center of the chest. Put your other hand on top. Keep your arms straight and your shoulders over your hands.

Push hard and fast.
Press down at least 2 inches on an adult chest, but not more than 2.4 inches. Let the chest come all the way back up between compressions. Aim for 100 to 120 compressions per minute.

Keep going.
Do not stop unless emergency responders take over, the person starts breathing normally, an AED is ready to analyze, or you are too tired to continue.

You do not have to do it perfectly. The biggest mistake is doing nothing.

How an AED helps

An AED, or automated external defibrillator, is a device that can check the heart’s rhythm and deliver a shock if one is needed. AEDs are designed for regular people to use, not just medical professionals.

Today, many workplaces, gyms, schools, airports, churches, and public buildings have AEDs nearby. If one is available, use it.

Turn the AED on and follow the voice prompts. The device will tell you what to do step by step. Place the pads on the person’s bare chest as shown in the pictures on the pads. Make sure no one is touching the person while the AED checks the heart rhythm.

If the AED tells you to give a shock, make sure everyone is clear, then press the shock button if instructed. After the shock, or if no shock is advised, start CPR again right away and keep following the AED prompts.

The AED will guide you. Listen to it, stay calm, and keep helping.

When rescue breaths may be needed

Hands-Only CPR is recommended for many adult sudden-collapse emergencies, especially when the person is unresponsive and not breathing normally.

There are times when conventional CPR with rescue breaths may be especially important, including:

• Drowning
• Drug overdose
• Children and infants
• Breathing-related emergencies
• Situations where the collapse may have been caused by lack of oxygen

This is one reason CPR training is so valuable. A good class gives you practice with chest compressions, rescue breaths, AED use, choking care, and different age groups.

Who is at higher risk?

Sudden cardiac arrest can happen to anyone, but some people have a higher risk. This may include people with:

• A previous heart attack
• Known heart disease
• High blood pressure
• Diabetes
• High cholesterol
• Smoking history
• Obesity
• Certain inherited heart rhythm conditions

Still, cardiac arrest can happen without obvious warning signs, even to people who seem healthy. That is why CPR and AED training should not be limited to healthcare workers.

Why CPR training matters

In a real emergency, it is normal to freeze for a second. Most people do. The room feels loud and quiet at the same time. Everyone looks around, hoping someone else knows what to do.

Training helps you get past that moment.

You know where to place your hands. You know how hard to push. You know how to use an AED. You know what to do until help arrives.

You may never need to use CPR. But if you do, those few minutes could make all the difference. CPR gives a person a chance they may not have had otherwise.

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