CPR overview for bystanders

Overview

CPR stands for cardiopulmonary resuscitation. It is an emergency procedure you can do to help someone whose heart has stopped beating (cardiac arrest). By pushing hard and fast on the chest, you keep blood flowing to the brain and other organs until professional help arrives.

Cardiac arrest happens to about 1 in 1000 people each year, but anyone can witness it. Bystander CPR is performed in only about 40% of cases, so your help can make a huge difference.

Anyone can need CPR, but it is most common in adults with heart conditions. Children may need CPR after drowning or choking. As a bystander, you might help a stranger, a family member, or a colleague.

Symptoms

Common symptoms

• The person is unresponsive – they do not wake up when you tap or shout.
• They are not breathing normally – gasping or no breathing at all.

Symptoms in children

• The child is limp and unresponsive.
• They are not moving or breathing, or are 'gasping' occasionally.

Symptoms in older adults

• Same as adults: unresponsive and not breathing normally.
• May have been complaining of chest pain or shortness of breath just before collapsing.

Causes

Main causes

• Heart attack – a blockage in the blood vessels of the heart.
• Drowning – lack of oxygen stops the heart.
• Electrocution or severe trauma.
• Drug overdose (especially opioids) – breathing slows or stops.

Risk factors

• Having a known heart condition, such as coronary artery disease.
• Smoking, high blood pressure, high cholesterol, or diabetes.
• Previous cardiac arrest or family history of sudden cardiac death.

When to see a doctor

Book a routine appointment if:

• If you witnessed a cardiac arrest and feel very upset, anxious, or unable to sleep, talk to your doctor.
• If you want to learn CPR, ask your local health service about training courses.

Diagnosis

As a bystander, you do not diagnose. You simply check if the person is unresponsive and not breathing normally. Call emergency services and start CPR. Emergency medical staff will confirm cardiac arrest later with an ECG (a heart tracing).

Tests that may be done

• An ECG to see if the heart is in a rhythm that can be shocked (defibrillated).
• Blood tests to check for heart damage or other causes.

What to expect at your appointment

If you perform CPR, the person may gasp, move a little, or even open their eyes. That is a good sign – keep going until paramedics take over or the person starts breathing normally.

Treatment

CPR is the immediate treatment a bystander can give. It keeps blood pumping to the brain and buys time for advanced medical care. The steps are: check for safety, call emergency, push hard and fast in the center of the chest, and use an AED (automated external defibrillator) if available.

Self-care at home

• Call your local emergency number right away.
• Start chest compressions: push down 5-6 cm (2 inches) at a rate of 100-120 compressions per minute.
• If trained, give 2 rescue breaths after every 30 compressions; if not trained, just do hands-only CPR.
• Use an AED as soon as it arrives – turn it on and follow the voice prompts.

Medical treatments

Once emergency services arrive, they may use a defibrillator, give oxygen, and administer medications to restart the heart. The person will be taken to hospital for further care, including possible tests and treatments for the underlying cause.

When is surgery considered?

If the cardiac arrest is due to a blocked artery (heart attack), the person may need an angioplasty – a procedure to open the blocked blood vessel. This is done in a hospital by a specialist team.

Living with this condition

After surviving a cardiac arrest, the person will need time to recover in hospital and at home. They may have weakness, memory problems, or emotional changes. A rehabilitation program can help them regain strength and adjust.

Lifestyle tips

• Follow a heart-healthy diet low in salt and saturated fat.
• Take all prescribed medications as directed by the doctor.
• Attend follow-up appointments and cardiac rehabilitation sessions.

Diet and exercise

A balanced diet rich in fruits, vegetables, whole grains, and lean protein supports heart health. Gentle exercise, such as walking, can be resumed gradually with medical approval. The healthcare team will give a personalized plan.

Mental health and emotional wellbeing

Cardiac arrest can be traumatic for both the survivor and the bystander. Feelings of fear, anxiety, or even guilt are normal. Talking to a counselor or joining a support group can help process these emotions.

Prevention

You can reduce your risk of having a cardiac arrest by managing heart disease risk factors: quit smoking, control blood pressure, eat well, exercise, and limit alcohol. Learning CPR means you are prepared to help someone else.

Screening programmes

If you have a family history of sudden cardiac death or certain heart conditions, your doctor may recommend screening, such as an ECG or echocardiogram.

Complications

If left untreated

• If no CPR is given, the person will die within minutes due to lack of oxygen to the brain.
• Even with CPR, delays can lead to brain damage or permanent disability.

Long-term outlook

The outlook for cardiac arrest has improved thanks to bystander CPR and public access defibrillators. With immediate CPR and defibrillation, many people survive and return to a good quality of life. Every second counts, and your willingness to help gives the person the best chance.

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