What to do if someone collapses at work

Why the first few minutes matter

When someone suddenly collapses, the cause could be anything from a faint to a cardiac arrest. In a cardiac arrest the heart stops pumping blood effectively, and every minute without CPR and defibrillation reduces the chance of survival. In the UK, fewer than one in ten people who have a cardiac arrest outside hospital survive. Early CPR and early use of a defibrillator can more than double those chances.

These steps follow Resuscitation Council UK guidance for adults. They are general guidance, not a replacement for hands-on training, and you should always follow the advice of the 999 call handler.

1. Check for danger

Before you approach, check that it's safe for you and others. Look for traffic, electrical hazards, machinery, fire or anything else that could hurt you. Don't become a second casualty.

2. Check for a response

Kneel beside them, gently shake their shoulders and ask loudly, "Are you all right?" If they respond, leave them where they are unless they're in danger, find out what's wrong, and get help. Call your first aider, and call 999 if you're concerned.

3. Shout for help, open the airway and check breathing

If there's no response, shout for help. Turn them onto their back if needed, then open the airway: place one hand on their forehead, tilt the head back and lift the chin with two fingertips.

Look, listen and feel for normal breathing for no more than 10 seconds.

Infrequent, noisy gasps are not normal breathing. This is called agonal breathing and is common in the first minutes of cardiac arrest. If you're not sure whether breathing is normal, act as if it isn't.

4. Call 999 and get a defibrillator

If they're not breathing normally, call 999 straight away and put the phone on speaker so your hands are free. Ask for an ambulance. The call handler will guide you through CPR and can tell you where the nearest registered defibrillator is.

Send someone to fetch a defibrillator (AED). If you're on your own, stay with the person and start CPR; don't leave them to look for one.

5. Start chest compressions

Place the heel of one hand in the centre of their chest, on the lower half of the breastbone, and put your other hand on top. Keep your arms straight, with your shoulders over your hands.

Press down 5 to 6 cm, at a rate of 100 to 120 compressions a minute, and let the chest come back up fully after each one. Keep interruptions to a minimum.

If you're trained and willing, give two rescue breaths after every 30 compressions. If you're not trained, or you're unable or unwilling to give breaths, do continuous chest compressions. Hands-only CPR is far better than doing nothing.

CPR is tiring. If someone else is there, swap every two minutes or so, with as little pause as possible.

6. Use the defibrillator as soon as it arrives

Switch it on and follow the voice prompts. Expose their chest and attach the pads as shown on the pictures, while someone else carries on with compressions if possible.

Make sure nobody is touching the person when the defibrillator analyses the heart rhythm or tells you to deliver a shock. Restart compressions as soon as it tells you to, whether or not a shock was given.

A defibrillator will only deliver a shock if one is needed, so you can't make things worse by using it.

7. Keep going

Continue CPR and follow the defibrillator's prompts until paramedics take over, the person shows clear signs of life such as waking, moving, opening their eyes and breathing normally, or you're too exhausted to continue.

If they're unresponsive but breathing normally

Put them in the recovery position, on their side with the head tilted back to keep the airway open, and call 999. Stay with them and keep checking their breathing. If it stops or stops being normal, roll them onto their back, call 999 again if you need to, and start CPR.

Some people have a brief seizure at the start of a cardiac arrest. Once the jerking stops, check their breathing again, and start CPR if it isn't normal.

Other common causes of collapse

Fainting: most people come round within a minute or so once they're lying flat. If they don't respond quickly, follow the steps above.

Low blood sugar in someone with diabetes: if they're conscious and can swallow safely, give them a sugary drink or glucose tablets, then something more substantial once they recover. If they're drowsy or unable to swallow, don't give anything by mouth; call 999.

Stroke: think FAST. Face drooping, Arm weakness, Speech problems: Time to call 999.

Seizure: protect them from injury, don't restrain them and don't put anything in their mouth. Time the seizure. Call 999 if it lasts more than five minutes, if it's their first seizure, if they're injured, or if they don't wake up afterwards.

Be ready before it happens

Make sure everyone knows where your defibrillator is, and check it regularly: the status light and the expiry dates of the pads and battery. Register it on The Circuit, the national defibrillator network, so that 999 call handlers can send people to it.

Know your exact address and how an ambulance crew gets in, including out of hours. When you call 999, send someone to meet the crew at the entrance.

And remember that a serious incident can affect the people who responded. Check in with them afterwards and make sure they know where to get support.

Practise before you need it

Reading about CPR is no substitute for practising it. On our courses your team practises CPR and defibrillator use on manikins with paramedic trainers, using scenarios based on your own workplace.