Stroke: Recognising FAST and Why Every Minute Counts
Around 1.9 million brain cells die every minute during a stroke. Recognising three simple signs and calling 108 immediately is the difference between recovery and lifelong disability.
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Cardiac arrest outside hospital is survivable — but survival roughly doubles when a bystander starts chest compressions. You do not need training or equipment, only the willingness to push hard and fast.
Recognising cardiac arrest
A person in cardiac arrest is unresponsive and is not breathing normally. Do not be misled by occasional gasping — irregular, noisy gasps in the first minutes are a sign of arrest, not of breathing. Do not spend time searching for a pulse; even trained rescuers get this wrong under pressure.
If you shake the person and shout and they do not respond, and they are not breathing normally, start compressions. The risk of doing compressions on someone who does not need them is far smaller than the risk of doing nothing on someone who does.
The steps
- Check the area is safe, then check response — tap the shoulders firmly and shout
- Shout for help and ask a specific person to call 108 and to find an AED if one exists nearby
- Place the person flat on their back on a firm surface
- Place the heel of one hand on the centre of the chest, on the lower half of the breastbone; place the other hand on top and interlock fingers
- Keep your arms straight and shoulders directly above your hands
- Push down 5–6 cm and release completely, at a rate of 100–120 compressions per minute
- Do not stop until the person shows signs of life, a defibrillator arrives, or trained help takes over
Worth knowing
The rhythm of the Hindi film song 'Baar Baar Dekho' — or a metronome at 110 beats per minute — matches the correct compression rate. Counting aloud helps keep pace when you are under stress.
Compression-only CPR is enough for untrained rescuers
If you have not been trained in rescue breathing, or you are unwilling to give mouth-to-mouth to a stranger, do compressions alone. Continuous, uninterrupted chest compressions produce outcomes comparable to compression-plus-breathing in adults who collapse suddenly, and they remove the two barriers that most often stop bystanders acting: hesitation and technique anxiety.
For children and for drowning or choking victims, where the arrest is caused by lack of oxygen rather than a heart rhythm problem, rescue breaths do add value if you are able to give them — thirty compressions to two breaths.
Common mistakes
- Pushing too gently — effective compressions require real force and often crack cartilage, which is acceptable
- Not allowing the chest to recoil fully between compressions, which stops the heart refilling
- Long interruptions to check the pulse or reposition
- Delaying the start while looking for a doctor, a vehicle or permission
- Assuming that because the person gasped, they are breathing
Legal reassurance
Bystanders in India are protected under Good Samaritan guidelines upheld by the Supreme Court. A person who helps an accident or arrest victim in good faith cannot be held liable for the outcome and cannot be compelled to become a witness. Fear of legal trouble should not stop you acting.
Key takeaways
- Unresponsive and not breathing normally means cardiac arrest — start compressions immediately.
- Push hard and fast in the centre of the chest, 5–6 cm deep, 100–120 times per minute.
- Compression-only CPR is appropriate and effective for untrained rescuers.
- Send someone to call 108 while you begin; do not delay compressions to make the call yourself.
A note on medical advice
This article is general health education written and reviewed by the Department of Emergency Medicine at SIMS. It is not a substitute for an examination, a diagnosis or the advice of your own treating doctor, and it cannot account for your history, medicines or reports. If a symptom is sudden or severe — chest pain, stroke symptoms, breathing difficulty, serious injury, seizures or heavy bleeding — call 9281862028 or come straight to the emergency department instead of reading further.
CPRCardiac arrestFirst aidEmergency