Cardiac arrest is one of the most time-critical medical emergencies a person will ever witness. When the heart stops pumping, the brain begins sustaining irreversible damage within four minutes. What happens in the minutes before an ambulance arrives and in the first hour at the hospital determines whether a person lives and in what condition.

In India, out-of-hospital cardiac arrest survival rates remain below 10%. This article explains what cardiac arrest is, how to recognise it, and what emergency care for cardiac arrest involves.

What Is Cardiac Arrest?

Cardiac arrest occurs when the heart's electrical system malfunctions and the heart stops beating effectively. Blood flow to the brain ceases. Within seconds, the person loses consciousness. Brain death begins within minutes without intervention.

It is not the same as a heart attack. A heart attack is a blocked coronary artery. Cardiac arrest is electrical and the heart's rhythm collapses entirely. A heart attack can trigger cardiac arrest, but they are distinct events requiring different immediate responses.

Causes of Cardiac Arrest

The most common cause in adults is ventricular fibrillation - a chaotic electrical rhythm that makes the heart quiver rather than pump. Triggers include:

Coronary artery disease and acute myocardial infarction
Cardiomyopathy (disease of the heart muscle)
Severe electrolyte abnormalities, particularly low potassium or magnesium
Drug toxicity, including cardiac medications at toxic doses
Congenital electrical abnormalities such as Long QT syndrome or Brugada syndrome
Severe trauma, drowning, or asphyxia particularly in younger patients.

Symptoms of Cardiac Arrest for Medical Emergency

Cardiac arrest is sudden and unmistakable:

Sudden collapse without warning
Unresponsiveness - cannot be woken by voice or touch
Absent or abnormal breathing like gasping, gurgling
No palpable pulse
Loss of colour like grey, blue, or ashen skin

If someone is unresponsive and not breathing normally, treat it as cardiac arrest immediately. Do not wait for warning signs.

First Aid for Cardiac Arrest (Before Reaching Hospital)

Bystander action in the first minutes is the single most important determinant of survival outside the hospital.

Step 1 - Call for help: Dial 108. Shout for someone nearby to call while you start CPR emergency care.
Step 2 - Begin chest compressions: Heel of one hand on the centre of the chest, other hand on top. Push hard and fast 5 to 6 cm deep, 100 to 120 per minute. Allow full chest recoil. Do not stop.
Step 3 - Add rescue breaths if trained: 30 compressions to 2 breaths. If untrained, hands-only CPR is effective.
Step 4 - Use a defibrillator if available: AEDs are in many public spaces. Switch on and follow the audio instructions. Resume CPR immediately after any shock.

CPR keeps oxygenated blood circulating until defibrillation or hospital treatment restores rhythm.

When to Seek Emergency Care for Cardiac Arrest

Cardiac arrest is always an emergency. Begin CPR immediately and call while someone else stays on the line. A conscious patient with the following also needs immediate emergency cardiac arrest treatment:

Chest pain or pressure lasting more than a few minutes, radiating to the jaw, arm, or back
Sudden severe breathlessness at rest
Brief loss of consciousness
Palpitations with light-headedness or near-fainting

These can precede arrest.

Emergency Treatment at Hospital for Cardiac Arrest

The resuscitation team takes over on arrival. Priorities are rhythm restoration and brain protection. Sudden cardiac arrest management includes:

Defibrillation: It converts ventricular fibrillation to a viable rhythm (most effective within the first minutes of arrest).
Airway management: Endotracheal intubation for controlled oxygenation.
Medication: Adrenaline every 3 to 5 minutes. Amiodarone or lignocaine for refractory shockable rhythms.
Post-resuscitation care: Targeted temperature management, haemodynamic stabilisation, and coronary angiography where indicated.

Diagnostic Tests for Cardiac Arrest

12-lead ECG: Identifies myocardial infarction and arrhythmic syndromes within minutes of return of circulation.
Echocardiography: Assesses ventricular function and structural causes.
Coronary angiography: Identifies and treats the ischaemic culprit lesion in appropriate patients.
Blood tests: Troponins, electrolytes, arterial blood gas, lactate, and toxicology screen.

Why Choose CARE Hospitals for Emergency Cardiac Arrest Care

CARE Hospitals are equipped with advanced infrastructure, experienced specialists, and rapid-response systems to deliver life-saving care:

24-hour resuscitation specialists on site, not on call
Round-the-clock catheterisation laboratory for emergency angiography and intervention
Structured post-arrest protocols covering temperature management, haemodynamic targets, and neurological monitoring
Emergency and cardiac teams integrated, escalation is protocol-driven, not referral-dependent
Post-arrest neurological support and rehabilitation planning

Activating the catheterisation laboratory or initiating cooling at CARE Hospitals is part of the resuscitation protocol, not a separate decision.

Conclusion

Cardiac arrest is survivable. The survival rate is not determined solely by hospital care but it is determined largely by what happens in the minutes before the ambulance arrives. Bystander CPR, early defibrillation, and immediate emergency services activation are the chain that keeps the brain alive long enough for hospital treatment to work. Know the signs. Start chest compressions. Call emergency services.

FAQs

1. What should I do if someone has cardiac arrest?

Call emergency services. Begin chest compressions - hard, fast, centre of chest, 100 to 120 per minute. Use an AED if one is nearby. Continue CPR until emergency services arrive. Every minute without CPR reduces survival by 7 to 10%.

2. Can cardiac arrest be reversed?

Yes, when the underlying rhythm is ventricular fibrillation and defibrillation is delivered promptly. Early bystander CPR more than doubles out-of-hospital survival. Outcome depends on the speed of intervention and the quality of post-resuscitation care.

3. How is cardiac arrest different from a heart attack?

A heart attack is a blocked coronary artery in which the heart keeps beating but the muscle is dying. Cardiac arrest is the sudden cessation of effective heart pumping due to an electrical malfunction. A heart attack patient is conscious; a cardiac arrest patient is not. A heart attack can trigger cardiac arrest.

4. What is the survival rate of cardiac arrest?

Out-of-hospital cardiac arrest survival in India is low. In settings with high bystander CPR rates and early defibrillation, survival exceeds by a lot. In-hospital arrest at well-equipped centres is significantly higher. Time to first shock is the strongest single determinant.

5. How effective is CPR in saving lives?

CPR circulates oxygenated blood to the brain until defibrillation or hospital treatment restores rhythm. Bystander CPR started immediately more than doubles survival. Hands-only CPR (compressions without rescue breaths) is effective and recommended for untrained bystanders.