Every second counts: How CPR can save a life

Members of the 28th Chinese medical team train a student in CPR during a free medical outreach in Dar es Salaam, Tanzania, on June 1, 2026. [Xinhua]

When someone collapses in a market, slumps in a matatu or falls unconscious during a football match, the first instinct is often to call an ambulance or rush them to hospital. But as bystanders scramble for help, precious minutes may slip away.

If the person's heart has stopped, waiting for medical assistance without doing anything could cost them their life.

Cardiopulmonary resuscitation (CPR), a technique that helps maintain blood circulation when the heart stops pumping effectively, can improve the chances of survival. Yet many people remain uncertain about what to do when faced with such an emergency.

“By the time an ambulance arrives, precious minutes may already have been lost. The person standing next to the patient could be the first to make a life-saving difference,” say Dr Barbara Karau, a consultant cardiologist, and Dr Salim Abdallah Salim, a cardiology fellow at Aga Khan University Hospital in Nairobi.

Their message is particularly relevant in Kenya, where traffic congestion, long distances and limitations in pre-hospital emergency services can delay access to medical care.

Cardiac arrest occurs when the heart suddenly stops pumping blood effectively, usually because of a malfunction in its electrical system. The person collapses, loses consciousness and stops breathing normally or begins gasping.

Without immediate intervention, the brain and other vital organs are deprived of oxygen, and death can follow within minutes.

Cardiac arrest is often confused with a heart attack, but the two conditions are different.

A heart attack occurs when blood flow to part of the heart muscle is blocked, usually by a clot in a coronary artery. The affected person may experience chest pain, sweating, nausea and shortness of breath.

Although a heart attack does not always cause cardiac arrest, it is a major trigger. Other causes include diseases of the heart muscle, inherited heart conditions and abnormalities in the arteries supplying blood to the heart.

Long-standing high blood pressure can cause the heart muscle to thicken, increasing the risk of dangerous heart rhythms. In young people, inherited conditions may go undetected until a sudden collapse during exercise or sport. Inflammation of the heart muscle following a viral infection can also trigger cardiac arrest.

The emergency is not always caused by an underlying heart condition. Drowning, choking, severe asthma attacks, major blood loss, blood clots in the lungs, overwhelming infections, dangerous electrolyte imbalances, drug overdoses and electrocution can also lead to cardiac arrest.

This means a person may collapse without any obvious warning, leaving those nearby with little time to respond.

The first step is recognising the emergency. If someone is unresponsive when spoken to or gently tapped and is not breathing normally, including when they are only gasping, cardiac arrest should be suspected.

Bystanders should not waste time trying to establish the exact cause.

Call emergency medical services immediately. If other people are present, ask someone to make the call and another to look for an automated external defibrillator (AED), if available.

If alone, call for help using the phone's speaker function, where possible, and begin CPR.

For hands-only CPR on an adult, place the heel of one hand at the centre of the chest, put the other hand on top and interlock the fingers. Keeping the arms straight, push hard and fast at a rate of 100 to 120 compressions per minute. Allow the chest to return to its normal position between compressions.

Continue until emergency responders take over, the person shows clear signs of life, or an AED instructs you to pause. Follow the emergency dispatcher's instructions where available.

For people without formal CPR training, hands-only CPR is a practical starting point when an adult suddenly collapses, is unresponsive and is not breathing normally.

“Do not let the fear of doing something wrong stop you from acting. When someone is unresponsive and not breathing normally, immediate action matters,” the cardiologists emphasised.

CPR does not necessarily restart the heart. Instead, chest compressions help circulate blood to vital organs while the person awaits further treatment. That circulation can buy valuable time.

In emergencies, reaching a hospital is only part of the challenge. The time spent waiting for an ambulance or navigating traffic may determine how long the brain goes without adequate oxygen.

“In an emergency, getting to hospital can take time. Equipping ordinary Kenyans with CPR skills could help bridge the critical gap between the collapse and the arrival of medical help,” the doctors say.

Wider CPR training could prepare teachers, security guards, public service vehicle drivers, sports coaches, students and other members of the public to respond to sudden medical emergencies.

Schools, workplaces, shopping centres and sports grounds are among the settings where training could prove useful.

“CPR should not be a skill reserved for doctors and nurses. Teachers, drivers, security guards, sports coaches and members of the public should know how to respond when someone's heart stops,” they say.

World Restart a Heart Day, observed annually on October 16, raises awareness of cardiac arrest and encourages people to learn CPR. The campaign highlights the role of bystanders, who may be the first to offer life-saving assistance before professional responders arrive.

For Kenya, the challenge is to turn that awareness into practical skills that people can use when emergencies occur.

An automated external defibrillator is another important link in the chain of survival. The portable device analyses the heart's rhythm and, when indicated, delivers an electric shock to help restore an effective rhythm.

AEDs are designed to guide users through the process using voice or visual instructions. They can be used by members of the public, including those without medical training, by following the device's prompts.

However, access to the equipment remains important. Making AEDs available in busy public spaces such as airports, shopping centres, stadiums and other high-traffic locations could strengthen emergency response.

“Installing defibrillators in public places is important, but the equipment alone is not enough. People must recognise cardiac arrest, call for help and begin CPR,” the doctors say.

Early chest compressions and rapid defibrillation, when indicated, can improve the chances of survival. Neither public training nor equipment can replace professional emergency care, but together they can strengthen the response before a patient reaches hospital.

Restoring the heartbeat is only the beginning. Urgent hospital treatment is needed to identify the cause of the arrest, stabilise the heart and protect the brain and other organs from the effects of oxygen deprivation.

Doctors must also assess the risk of another cardiac arrest and determine what treatment is necessary.

Survival depends on several connected steps: recognising the emergency, starting CPR, using a defibrillator when indicated, providing advanced emergency care and ensuring appropriate hospital treatment. Delays at any stage can reduce the chances of survival.

Ultimately, improving outcomes requires more than well-equipped hospitals. It also requires people who know how to respond when someone collapses beside them.

“You do not need to be a doctor to help save a life. You need to recognise the emergency, call for help and know what to do next,” the cardiologists say.

Learning CPR, encouraging others to train and improving access to defibrillators could help more Kenyans respond confidently when every second counts.