Why Sudden Cardiac Arrest Deserves a Place on Your Workplace Agenda

Sudden cardiac arrest happens when the heart stops pumping blood effectively. It is not the same as a heart attack, although the two are often confused. A heart attack is a circulation problem; a cardiac arrest is an electrical one, and it can strike someone who looks perfectly well, with no warning at all. Every year in the UK, thousands of people collapse outside hospital, and a significant number of those events happen at work — in offices, warehouses, schools, shops, gyms and building sites.

The encouraging part is that survival is not left to chance. When a colleague recognises what is happening, calls 999 quickly, starts chest compressions and gets a defibrillator onto the casualty's chest, the odds improve dramatically. For every minute that passes without CPR and defibrillation, the chance of survival falls by roughly ten per cent. That means the first few minutes belong to the people standing nearby — not to the ambulance crew, however fast they arrive.

This article walks through what to do in the moment, and then what to put in place beforehand so that your team is ready rather than rattled.

Recognising the Signs and Assessing the Scene

Before you touch anyone, take a few seconds to look around. Your safety comes first, because a helper who becomes a casualty helps nobody. Check for traffic, moving machinery, live electrical equipment, spills, fire or anything else that could harm you. Only approach when it is safe to do so.

Once you are beside the person, follow a simple sequence:

• Check for a response. Kneel beside them, tap their shoulders firmly and ask loudly, "Are you all right?"
• Check their breathing. Tilt the head back gently, lift the chin, and look, listen and feel for normal breathing for no more than ten seconds.
• Be suspicious of gasping. Occasional slow, noisy, snoring gasps are not normal breathing. In the first minutes after a cardiac arrest, this is common — and it is still a cardiac arrest.

If they are unresponsive and not breathing normally, treat it as cardiac arrest and act immediately. Do not delay to search for a pulse if you are unsure. If they are breathing normally but unresponsive, place them in the recovery position and keep monitoring them until help arrives.

Calling 999 and Getting the Right Help Moving

Shout for help before you start. In a workplace there are usually people within earshot, and delegating clearly is far more effective than hoping someone steps forward. Point at a specific person and give a specific task.

• "You — call 999 now, put it on speakerphone, and tell them we have an unresponsive adult who is not breathing normally."
• "You — go and fetch the defibrillator. Tell me where it is and bring it here."
• "You — meet the ambulance at the main entrance and bring them straight to us."

When the call connects, the ambulance call handler will talk you through CPR and defibrillator use step by step. Stay on the line, keep the phone on speaker and follow their instructions. Give the exact address, the postcode, the building name and the best access point. If someone else can unlock doors, clear lifts or move vehicles blocking the entrance, ask them to do it now rather than later.

Starting CPR Without Hesitation

Effective CPR is simpler than many people fear. If you are unwilling or unable to give rescue breaths, or you have not been trained, do hands-only CPR. It saves lives.

• Place the heel of one hand in the centre of the chest, on the breastbone, and put your other hand on top with fingers interlocked.
• Keep your arms straight, position your shoulders directly above your hands, and press down hard and fast.
• Aim for a depth of about 5 to 6 centimetres — roughly a third of the chest depth.
• Push at a rate of 100 to 120 compressions per minute. The beat of "Stayin' Alive" is a good guide.
• Let the chest come back up fully between compressions, and keep going. Do not stop to rest unless someone else takes over.

Swap with a colleague every two minutes if you can — fatigue creeps in quickly and compressions become shallow. If you have been trained and are confident, give 30 compressions followed by 2 rescue breaths, and continue that cycle.

Using an Automated External Defibrillator

An AED is designed for untrained users, so do not be intimidated. It will analyse the heart rhythm and only deliver a shock if one is needed. Once it arrives, switch it on and follow the spoken prompts.

• Bare the chest and dry it if it is wet. Remove any medication patches and wipe the skin.
• Attach the pads as shown on the diagrams — one below the right collarbone, one under the left armpit.
• Ensure nobody is touching the casualty while the device analyses the rhythm, then stand clear and press the shock button if instructed.
• Resume compressions immediately after the shock and continue until the person shows clear signs of life or the ambulance crew takes over.

If the casualty has a hairy chest, the kit may include a razor; if they have a pacemaker, place the pad at least 8 centimetres away from it. Never delay defibrillation to move someone unless the environment is genuinely dangerous.

Preparing Your Workplace Before Anything Happens

Preparation turns panic into muscle memory. A few practical steps make an enormous difference.

• Know your equipment. Confirm where your nearest defibrillator is, whether it is on site or in a community cabinet nearby, and how to access the code if one is needed.
• Check your first-aid provision. Under UK first-aid regulations, employers must assess their needs and provide adequate equipment, facilities and trained personnel. Review that assessment rather than filing it away.
• Book annual training. Hands-on CPR and AED practice, refreshed yearly, builds real confidence. Include lone workers, shift staff and cleaners.
• Sign and publicise. Make sure defibrillator locations are clearly signposted and included in induction packs.
• Run a drill. A short scenario exercise once a year exposes problems with access, alarms and communication before they matter.

You cannot predict when a colleague's heart will stop. You can decide, today, that your workplace will be ready when it does.