Know the difference between a heart attack and sudden cardiac arrest – and three steps that can save a life
You don't need medical training to help when someone suddenly collapses. You do need to know where to begin. During Sudden Cardiac Arrest Awareness Month in October, it's worth learning the difference between a heart attack and cardiac arrest — and what to do when minutes matter.
A heart attack is a circulation problem — think “plumbing.” Blood flow to the heart muscle is blocked, often by a blood clot forming around plaque in an artery. A person having a heart attack may stay conscious and continue breathing while experiencing chest pain, shortness of breath, sweating or nausea. Symptoms can start suddenly or gradually and may be surprisingly mild. If you suspect a heart attack, call 911.
Sudden cardiac arrest, by contrast, is an “electrical” problem. An abnormal heart rhythm disrupts the heart's ability to pump blood to the brain and the rest of the body. The person may suddenly collapse, become unresponsive and stop breathing normally. When that happens, minutes matter.
“A heart attack can increase the risk for and is a common cause of sudden cardiac arrest, but not all heart attacks lead to cardiac arrest,” explained Garrett Cordes, Injury Prevention coordinator for Washington Health. “Other heart conditions can also trigger cardiac arrest.”
Acting quickly
If an adult or teen suddenly collapses, is unresponsive and isn't breathing normally, remember three actions: Call 911. Start hands-only CPR. Use an automated external defibrillator (AED) as soon as one is available.
Check for a response and normal breathing. If the person is unresponsive and not breathing normally — or is only gasping — call 911. Put the phone on speaker, give the dispatcher your location and follow instructions. Begin chest compressions immediately; the dispatcher can guide you. If the person is breathing normally, don't begin CPR. Stay with them and follow the dispatcher's instructions while watching for changes.
Hands-only CPR means continuous chest compressions in the center of the chest, without mouth-to-mouth rescue breaths. Compressions help keep blood circulating to the brain and other vital organs until emergency responders arrive. For an adult, push at least 2 inches deep at a pace of 100 to 120 compressions per minute, allowing the chest to rise fully after each push.
“Hands-only CPR is just pushing hard and fast,” he explained.
“You don't have to remember a complicated sequence of steps,” Cordes continued. “You don't have to be perfect. You just need to start and keep going.”
Need help finding the rhythm? Cordes recommends the beat of the Bee Gees' “Stayin' Alive.”
Cordes said uncertainty can cause bystanders to hesitate. But when someone is unresponsive and not breathing normally, starting CPR gives them a chance while emergency help is on the way.
Ask someone nearby to bring an AED while CPR is underway. Use it as soon as it arrives. AEDs are found in many public places, including sporting venues. Cordes recommends noticing the AED's location whenever you enter a public building.
AEDs guide people without medical training. Turn on the device and follow its voice prompts. It will show where to place the pads and when to stand clear as it analyzes the heart's rhythm. The AED delivers a shock only if needed.
“The big thing is don't be scared to jump in,” he stressed. “Continue until EMS takes over, the AED is ready to analyze or deliver a shock, or the person shows obvious signs of life.”
Practice to save a life
You may never need to perform CPR, but Cordes said learning the skill in a class can help make the steps familiar, especially for people who care for children.
Hands-only CPR is intended for adults and teens. A full CPR course teaches additional skills, including rescue breaths for infants and children, and addresses choking and other emergencies. Training can be especially valuable for parents, grandparents, babysitters and other caregivers.
Practice also gives people the opportunity to build confidence. Alameda County EMS has prioritized community CPR training through its Ready to Respond Initiative. Washington Health is participating through injury prevention programs, including fall prevention classes and community events, and an educational CPR video on YouTube.
The goal isn't to turn everyone into a paramedic. It's to make the response to a sudden collapse familiar enough to put those steps into action.
Call 911. Start compressions. Use an AED when one is available.
You don't have to know everything to help save a life.
To learn about Washington Health injury prevention programs, visit washingtonhealth.com/trauma. To learn hands-only CPR, watch the CPR episode on youtube.com/@Washington_Health.