BLS Certification Manual: Recognizing Cardiac Arrest

ASSESS SCENE SAFETY

The rescuer needs to first assess the safety of the scene, so as not to put themselves, the victim or others at risk. An example of assessing scene safety would be to ensure that no vehicles are coming into a busy intersection or crosswalk where a victim lies unresponsive.

CHECK FOR RESPONSIVENESS

The rescuer will then need to check an adult or child victim for responsiveness by shouting, “Are you okay?” and physically shaking the victim to see if there is a response. Checking for responsiveness is crucial in identifying cardiac arrests, as the absence of responsiveness and normal breathing are key indicators. The rescuer should continually be assessing the victim for breathing by watching for chest rise and fall as well as listening and feeling for breathing. If the victim is not breathing and the rescuer cannot assess a pulse, a call for help should be placed. It is important to maintain blood flow through CPR if the victim is unresponsive and not breathing. For infants, the best way to check responsiveness is tapping the bottom of the foot.

CALL FOR HELP

If an adult victim is unresponsive, the rescuer will need to designate a bystander to call for help. If no bystander is available, the rescuer should call for help and then start CPR. After establishing contact with your emergency provider, the rescuer should place his/her phone on speaker, to listen for instructions while performing CPR. Effective chest compressions are crucial to maintain circulation until an automated external defibrillator (AED) is available. Using an AED as soon as possible can significantly increase the chances of survival by delivering an electric shock to restore the heart's normal rhythm.

If a child or infant victim is unresponsive, the rescuer should first check for breathing and signs of life. If the rescuer is alone and no one else is available to activate the emergency response system, CPR should be performed for about two minutes before leaving the victim to call for help and retrieve an AED, if available. This initial period of CPR is important because cardiac arrest in children and infants is often caused by respiratory problems, meaning oxygen and circulation must be restored as quickly as possible. After contacting emergency services, the rescuer should return immediately to the victim and continue CPR, providing high-quality chest compressions along with rescue breaths. If an AED becomes available, it should be used as soon as possible, following the device’s voice prompts while continuing care until professional medical help arrives.

Fast Fact:  Each minute that passes without CPR after a sudden cardiac arrest (SCA) reduces the victim’s chance of survival by approximately 10%.

RETRIEVE AN AUTOMATED EXTERNAL DEFIBRILLATOR (AED)

After the victim has been determined to be in need of CPR and additional help has been called, the rescuer will need to assign another bystander (if possible) to retrieve an AED if available. An automated external defibrillator (AED) works by delivering an electric shock to restore the heart's normal rhythm. It is crucial to restore the flow of oxygen-rich blood to the organs to prevent further damage.