Anyone can help!
If you witness cardiac arrest: immediately alert the Emergency Medical Service (EMS) via the emergency number 144 and start CPR. Do not bother to read the following information, which is designed as additional course material only.
144 for all medical emergencies
The following statements are made in accordance with (inter)national guidelines, as well as they are updated and revised to the best of our knowledge. They are in no way a substitute for specific training. Their application requires expertise, experience and situational flexibility. The actions described explicitly presuppose the user's mastery of the measures and must not replace or delay alerting the emergency medical service EMS. In case of doubt, consult a physician or emergency medical service EMS.
In two chapters, medications are listed (aspirin for non-traumatic chest pain and epinephrine auto-injector for severe allergic reaction) in accordance with international recommendations. We expressly point out that the legislator in Switzerland legitimizes the corresponding drug administration only for medical professionals, which is why the use or the delegation framework must be clarified in advance and for the specific conditions of the user and institutional setting. In this regard, SIRMED does not assign competencies to first aiders.
Attention: Despite all care taken in the editorial preparation, errors can never be completely excluded. Therefore, no legal guarantee can be assumed for the information provided. The user must always keep up to date with the latest literature. We are grateful for constructive criticism and suggestions for improvement. Any liability claims resulting from the use of the following statements are rejected.
By continuing to read at this point, you declare that you have read and understood the instructions for use and accept the statements on disclaimers and responsibilities in all points.
A cardiac arrest quickly and in any case ends fatally if no help is provided. The chances of survival can be improved by the immediate help of those present. The basic life-saving measures are easy to learn and to apply. Chest compression has the highest priority. This means:
- 30 compressions alternating with 2 ventilations
- 100 to 120 compressions per minute
- 5 to 6 cm deep
- defibrillation can be life-saving
- while self-protection of the helper is above all!
- A cardiac arrest often occurs completely unexpectedly and requires immediate resuscitation attempts.
- For First Responders, their own safety is first priority. An approach to the patient may only be made when it is clear that there is no danger (electricity, gas, traffic, etc.)
- In case of doubt, wait for the arrival of professional rescuers.
Recognition and assessment of emergency situations
- First Aid always begins with an assessment of the situation and the patient.
- It is about recognizing if the patient is acutely threatened and needs immediate life-saving measures.
- Patients can be divided in three groups:
- Awake, responsive and able to respond. Needs can be expressed.
- First Aid can be coordinated with the affected person.
- Usually not an immediate threat to life.
- Unconscious without reaction to touch and loud address, but normal breathing.
- Potentially life-threatening
- A recovery position can be life-saving. Since life-threatening situations have priority, this also applies to suspected back injuries. The aim is to keep the airways open.
- The patient should be monitored and cared for at all time until EMS arrives and the breathing should be checked repeatedly.
Patient in cardiac arrest
- Unconscious without reaction to touch and loud addressing.
- In addition, no, or unnormal respiration recognizable.
- Acute danger to life requires immediate resuscitation matters.
- Alert, chest compression, rescue breathing and defibrillation required.
- In case of serious medical emergencies, EMS is to be called immediately via phone number 144.
- The time between the onset of symptoms and medical assistance should be as short as possible!
- Further emergency numbers:
118 fire department
145 poison emergency call
112 european emergency number
Causes of cardiac arrest and prevention
- There are many causes for a cardiac arrest. Among the most common are: heart attack, lung embolism, foreign body airway obstruction (FBAO), stroke, serious injury, etc.
- Some risk factors favor heart attack and stroke. Some of these can be influenced. This means that these diseases can be prevented to a certain extent.
- Increased blood lipids, smoking, high blood pressure, overweight, diabetes and lack of exercise, are avoidable and to a certain extent reduce the personal risk.
Heart attack is one of the most common causes of death worldwide. In most cases, the blood supply to the heart is interrupted.
Typical signs of a heart attack are
- severe chest pain, pressure or burning
- shortness of breath
- blue discoloration of the lips
- feeling of destruction
- nausea, vomiting
- sweat breakout
- For First Responders, recognition and alerting is already most important. Do not lose any time!
- In addition, affected people should be cared for until EMS arrival.
Strokes often end fatally or cause lifelong disabilities. Early detection and hospitalization can be life-saving.
Typical signs of a stroke are
- facial paralysis (the affected cannot whistle for example)
- hemiplegia (the affected person cannot keep the arms stretched out to the same side)
- speech disorders (the affected person cannot speak or is speaking unclearly)
- For First Responders, recognition and alerting is already most important. Do not lose any time! In addition, affected people should be cared for until EMS arrival.
Disturbance of consciousness
- Disturbances of consciousness can be caused by injury, illness or poisoning.
- The greatest danger is choking when the tongue sinks back and blocks the airways while lying on your back or when vomit enters the lungs.
- Person lies motionless on the floor
- Does not respond to speech
- No opening of the eyes
- No other movements
- Normal breathing is visible
- Alerting of EMS via emergency number 144
- Unconscious positioning: to keep the airways open in recovery position
- Heat retention, for example by means of a rescue blanket (gold-silver foil)
- Afterwards, stay at the patient's head and assess whether breathing remains normal until the rescue service arrives
Respiratory tract relocation
Airway obstruction can be caused by any kind of foreign matter, especially food, but with small children also especially toys.
- Sudden shortness of breath or coughing
- Possibly respiratory arrest
- Asphyxiation fear
- Bluish skin discoloration
Children under 1 year
- 5 blows on the back
- 5 chest compressions alternating
Children over 1 and adults
- Blows on the back
- If unsuccessful: Heimlich maneuver
- If still unsuccessful: chest compression
- For unconsciousness: Basic Life Support
- In Switzerland there is about one cardiac arrest per 1000 inhabitants every year.
- Worldwide only about 10% survive such an event.
Today we know that:
- immediate resuscitation (reanimation) doubles the chances of survival;
- basic life support including defibrillation within 3 to 5 minutes allow survival rates of over 50%;
- every minute delay in defibrillation reduces the chances of survival by about 10%.
- So, do not lose any time!
- Defibrillation refers to electroshock therapy. Its' aim is to end the most common cardiac arrythmia in people in cardiac arrest.
- Speed is of the essence: For every minute of delayed defibrillation, the chances of survival decrease by about 10%
- After turning on the device, the action steps are carried out to the voice instructions of the device. A single shock is applied, followed by two minutes of CPR. Every 2 minutes the heart rhythm is checked again by the device and, if necessary, another shock is delivered.
- To use a defibrillator, place the patient flat and dry.
- Attach pads on to the bare chest as shown in the illustration and press firmly.
- Safety control and shock warning.
- Nobody must touch the patient.
- Perform Basic Life Support while defibrillation is being prepared.
- The interruption for defibrillation must be short.
- After defibrillation, proceed immediately with 30 chest compressions.
- To ensure a safe defibrillation, some basic rules must be observed:
- Use only on an unconscious patient in respiratory arrest.
- Do not use on conductive surfaces or in explosive environments.
- If the patient is lying in the wet or is wet with sweat, move to dry ground and dry off the chest.
- Defibrillation on snow or ice is not dangerous.
- Heavy chest hair may need to be shaved.
- If the patient has a recognizable pacemaker – attach pads beside to it.
- If the patient is wearing medication patches on the chest – remove the patches and wipe the skin.
- With pregnant women, on the other hand, no special precautions need to be taken.
- Different pictograms are used to signal AED locations. The one shown here is recommended for Switzerland.
Resuscitation is carried out until
- professional rescuers take over the measures;
- the patient is breathing normally again;
- a physician or the rescue team interrupts resuscitation;
- or the own performance limit is reached.
- Even though children are not small adults, Basic Life Support measures are performed almost the same way.
- To an unresponsive child with no or unnormal breathing chest compression and ventilation is given at a ratio of 30 chest compressions alternating with 2 ventilations.
- The measures are of course performed less vigorously than with an adult.
- The depth of chest compression is one third of the diameter of the chest.
- Ventilation has a higher priority in resuscitation of children than in adults and should always be performed if possible.
- If available, special pediatric electrodes should be used when defibrillating children (if possible) If these are not available, normal pads are used.
- Art 128. of the Swiss Penal Code (StGB) makes it a punishable offense to fail to render assistance in cases of danger to life.
- Wrong or not indicated measures can injure the person concerned.
- No injury is more serious than neglected resuscitation efforts.
- With BLS and AED to the best of one's knowledge and belief, legal consequences are practically excluded