Cardiac Arrest in a Crowded Gym
You are working out at a busy gym when a 55-year-old man collapses on a treadmill. You and another member rush to him. He is unresponsive and not breathing. You see a nearby AED on the wall, about 20 feet away. The gym is noisy, and there are many people around. Another person is calling 911. You have gloves but no barrier device for breaths. The man is sweaty, and his chest is bare. You are not sure if he has a pulse, but you know he is not breathing. The AED is in a cabinet that requires a code, but the code is written on the cabinet. A gym employee is nearby but not trained.
1. What is your immediate course of action?
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The man is unresponsive and not breathing, which indicates cardiac arrest. Start CPR immediately. Send the gym employee to get the AED (tell them the code is on the cabinet). Begin chest compressions at 100-120/min, depth at least 2 inches, allowing full recoil. Because you have no barrier device, you can perform compression-only CPR. Do not delay compressions to check for a pulse; you are unsure, but the absence of breathing is enough to start CPR. Continue until the AED arrives or EMS takes over.
2. The AED arrives, and you apply the pads. The AED prompts: "Shock advised. Charging. Stand clear." What do you do?
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Ensure no one is touching the victim. Loudly say "Clear!" and visually check that everyone is clear. Press the shock button when prompted. Immediately after the shock, resume CPR starting with chest compressions. Do not pause to check for a pulse or breathing; the AED will reanalyze in 2 minutes. Continue CPR until the AED prompts for another analysis or until EMS arrives. If another rescuer is available, switch compressors every 2 minutes to maintain quality. Keep the AED pads on the victim's bare chest and follow all prompts.