Unconscious, unresponsive, not breathing normally: how to spot sudden cardiac arrest

Unconscious, unresponsive, not breathing normally: how to spot sudden cardiac arrest

We recently recorded a conversation with Monash University Ph.D. Scholar, Brian Haskins where we delved deeply into many of the reasons why out-of-hospital cardiac arrest (OHCA) is such an insidious problem worldwide, and some of the specific challenges Brian’s research is focussing on addressing.

In the first few minutes of the clip of that conversation that you’ll find here, Brian, who trains CPR trainers, gave an excellent summary of what a bystander – that is, someone who witnesses another person go into sudden cardiac arrest – should look for and do in that moment.

“We really tried to make it (simpler) for people to recognise a cardiac arrest.  They just have to look that someone’s unconscious, unresponsive, and not breathing normally.  We’re not asking bystanders now to check for a pulse because people get confused and they don’t know how to do that, and they don’t take a pulse properly.

“So, if people are unconscious and not breathing properly, we want them to call emergency services.  The reason they have to do this is, as soon as they call the operator…paramedics can be dispatched.”

One of the symptoms Brian is referring to, is agonal breathing.  When someone goes into sudden cardiac arrest, they may start gasping, or even moaning – which is an automatic reflex resulting from the fact that the heart has stopped circulating oxygen-rich blood.

Brian goes on to talk at length about the importance of early defibrillation in the event of an out-of-hospital cardiac arrest, to improve chances of survival for the patient.  According to Brian, CPR is not enough; defibrillation is also needed to ensure a patient can be revived once emergency medical services arrive on the scene.

The fact that global out-of-hospital cardiac arrest survival statistics are estimated to be as low as one per cent is testament to not enough people receiving early defibrillation.

This is not just about there being enough public access defibrillators around.  For example, this study in the US found that in nearly half of investigated cases of out-of-hospital cardiac arrest that happened near an AED (automated external defibrillator), the AED was not used.

The research “suggests that public awareness and accessibility of AED locations should be improved.”  Anyone working in this sector knows that the problem also includes bystanders recognising what an AED is for, and being confident enough to use it at the moment of need.

The inference is that the problem goes beyond knowing how to spot a sudden cardiac arrest.  The key is knowing what to do once it happens in front of you.

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