If you witness a cardiac arrest, your actions could save a life. Here’s what to do

A cardiac arrest can happen at any time to almost anyone, and experts say the actions of a bystander can mean the difference between life and death.

There are roughly 60,000 cardiac arrests outside hospitals in Canada every year, according to 2021 data from the Canadian Resuscitation Outcomes Consortium (CanROC), a national group made up of researchers, scientists and medical responders.

Only one in 10 people who experience a cardiac arrest out of hospital survive — and nearly half of those 60,000 incidents happen to people under age 65, according to a recent report from Heart and Stroke.

You don’t need to have official CPR training to jump in and help, said Tisha White, resuscitation program manager for Atlantic Canada with Heart and Stroke.

“We just want people to do something rather than nothing,” said White.

“Every minute that goes by that we’re not doing something with hands-on compressions or AED, the chance of someone’s survival is reduced.”

What is cardiac arrest?

The number of out-of-hospital cardiac arrests has gone up significantly over the past few years, partly due to more accurate estimates. Other reasons for the increase could be an aging population, the COVID-19 pandemic, and the opioid crisis, say experts.

The cause of cardiac arrest is an electrical problem that stops the heart from beating.

“Think about it as if a breaker is turned off. There is no blood that is being pumped from the heart to the brain or the rest of the vital organs,” Dr. Roopinder Sandhu told Dr. Brian Goldman, host of CBC’s The Dose.

This is different from a heart attack, which is a blockage of one of the blood vessels in the heart.

When someone experiences a cardiac arrest, it’s key to act quickly, say experts, which is why Heart and Stroke uses the term “chain of survival” to list the steps people can take to help before medical professionals arrive:

• Recognize the cardiac arrest and call 911.
• Start CPR with an emphasis on chest compressions.
• Quickly defibrillate using an automated external defibrillator or AED.

‘Unresponsive and not breathing’

How do you know that someone may be in cardiac arrest?

“They’re going to collapse. They’re going to be unresponsive and not breathing. And if they are breathing, they’ll have gasping sounds that you might hear,” said Sandhu, a professor in cardiac sciences at the University of Calgary.

Once you see those signs, call 911 and if there is anyone else nearby, shout for them to bring an AED if available, she said. The devices, now commonly found in sports facilities and some businesses, analyze someone’s heart rhythm and can administer an electric shock if necessary.

Step 2: start CPR on the person right away.

“CPR can save lives. And you’re not going to do any harm to these people by doing CPR until the professional arrives,” said Dr. Sean van Diepen, a cardiologist and intensivist at the University of Alberta in Edmonton.

How to do CPR

Most bystanders are not trained in mouth-to-mouth resuscitation, said White, which is why it’s not included in the steps to take for basic CPR.

Even without it, chest compressions are what is going to keep the blood flowing to the brain and other vital organs, experts say.

“You’re placing the heel of your hand in the centre of the chest, you’re interlocking your fingers of your other hand on top, and you’re pushing hard and fast,” said Sandhu.

The compressions should be about five centimetres deep, said White, or the height of a credit card.

“You want to position your shoulders right over top of someone and really push using your upper body, as opposed to letting your arms bend every time,” she said.

Press in a quick rhythm, about 100 to 120 beats per minute. To stay in time, sing Stayin’ Alive in your head — or a song with a similar beat.

Keep going — even if you’re worried you’re not doing it right, said van Diepen.

“Even if it’s not as fast as a professional, you’re doing something and you’re delivering blood flow and oxygen to the brain,” he said.

How to do basic CPR when someone’s heart stops

When someone goes into cardiac arrest, cardiopulmonary resuscitation, or CPR, is one of the best ways to give them a shot at survival. Chris Schmied from St. John’s Ambulance walks health reporter Lauren Pelley through the basic steps.

How a defibrillator works

If someone brings you an AED, stop the compressions and start using it, experts say.

AEDs analyze the person’s heart rhythm and deliver a shock to the heart if necessary.

The device has an audio component that walks you through how to use it, said White, as well as pictures of where to place the pads on someone’s chest.

“I think a lot of times the fear is that, ‘Well, what if I do something and I do it wrong.’ But AEDs have become so advanced that it’s not going to shock someone unless they need it,” White said.

The AED will also tell you when to continue chest compressions — which you should do until the ambulance arrives.

Gender imbalance

Studies have shown that women are less likely to receive CPR in public than men, said White.

“There’s a reluctance for people to put hands on women, especially on women’s chests,” she said.

“There’s a level of like, ‘I shouldn’t be doing this because it’s a woman.’ And at the end of the day that actually impacts us as women and our survival rates from cardiac arrest.”

White hopes by raising awareness of this issue, more people can recognize the importance of doing CPR regardless of someone’s gender.

Others may be concerned about hurting the person — regardless of gender — by pressing too hard or deep on their chest, but experts say the benefits of giving CPR far outweigh those risks.

You can also give CPR to children and babies, though you may need to modify it depending on their age.

More education needed

For those who want to learn more about CPR and basic life support, there are many types of training available, including classes from Heart and Stroke and other groups.

Experts say if you don’t have time for that, you can take just a few minutes and learn the basics on YouTube.

White hopes more education about cardiac arrest and CPR will create more awareness among young people.

“If we can have a generation of kids growing up who know and who can feel comfortable knowing what to do in that situation, I think that’s a great start,” she said.