How do we know sudden cardiac arrest when we see it?

That’s the question asked by the authors of Please. Don’t. Die. – A Grounded Theory Study of Bystander Cardiopulmonary Resuscitation (Mausz et al, 2018).

They found that while CPR training has been simplified to improve participation and promote bystander intervention:

“…current methods of CPR instruction may not adequately prepare lay rescuers for the various logistical, conceptual, and emotional challenges of resuscitating a victim of cardiac arrest.

“Taking action to save the victim is complicated by several misconceptions about cardiac arrest, where victims are mistakenly believed to be choking, and agonal respirations are misinterpreted to mean the victim is alive.

“Making sense of the experience is challenging, at least in the short term, where lay rescuers have to contend with self-doubt, unanswered questions, and uncomfortable emotional reactions to a traumatic event.”

Related article: panic a barrier to saving lives from sudden cardiac arrest

Unconscious, unresponsive, not breathing normally

While more than six million people die annually from sudden cardiac arrest, it’s unlikely most of us will never see one.

That is, unless we’re a trained first responder like Monash University’s Brian Haskins – whose job includes training CPR trainers.

According to Brian, CPR trainers are looking to instill that first call to emergency medical services (EMS).   This should be the automatic response if someone falls, is unresponsive and not breathing normally.

That lack of normal breathing is what is referred to above as “agonal respirations”.  According to this guide, agonal breathing could sound like gasping, snorting, moaning or laboured breathing.

The fact that gasping is a sign of cardiac arrest may not occur to most people.

As Brian Haskins says, we can’t expect everyone to know a sudden cardiac arrest when we see it.

We do however, need the sight of someone collapsing, struggling for air and losing consciousness, to trigger that first step in the Chain of Survival: call emergency services.