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Out-of-hospital arrest

Up Defibrillation In-hospital arrest Out-of-hospital arrest Prognosis after arrest

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Charles Gomersall

First posted June 2006

NB This webpage is intended for healthcare professionals and students only

The management of the collapsed patient outside a healthcare environment is outlined in the figure.

A number of points related to this management need to be remembered.

  • In this situation consciousness is assessed by shaking the patient’s shoulders gently and checking his/her ability to make an intelligible response to the question “Are you all right?”

  • Check for breathing by looking, listening and feeling for a maximum of 10 secs

  • Agonal, gasping breathing is a sign of cardiac arrest or near cardiac arrest. Treat the patient as if he/she is not breathing

  • If you are on your own and do not have a mobile phone and it is necessary to call an ambulance, leave the patient to do so

  • Breaths can be provided by mouth-mouth, mouth-nose or mouth-mask ventilation. There are only isolated reports of transmission of infection to providers of mouth-mouth ventilation. There are no reports of transmission of HIV. Nevertheless if you are unwilling to provide mouth-mouth ventilation it is still worthwhile to provide chest compressions even without providing ventilation

  • Do not provide mouth-mouth ventilation to victims of cyanide poisoning or who have been exposed to toxic agents

  • Stop chest compressions and ventilation only when the patient starts regular breathing of normal depth

  • If an automatic defibrillator is available, use it

©Charles Gomersall, October, 2009 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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