What to actually do in the first 60 seconds of a cardiac arrest

Someone collapses. They aren't responding and they aren't breathing normally — maybe there's a gasp every few seconds, which is not breathing. That's a cardiac arrest, and from that moment their odds fall roughly ten percent for every minute nobody pushes on their chest.

Point at a specific person and say "you, call 911 and come back." Vague instructions to a crowd get ignored. Then point at another person and say "you, find the AED." Almost every school, gym, camp, and office building in Westchester has one, usually in a wall cabinet near the main entrance.

Then start compressions. Heel of your hand on the center of the chest, other hand on top, arms straight, push down about two inches and let the chest come all the way back up. Fast — around two per second. It will feel violent. It's supposed to. Broken ribs heal; brains without oxygen don't.

If you're untrained or unwilling to give breaths, keep doing compressions and nothing else until help arrives. Hands-only CPR is dramatically better than waiting. If you are trained, 30 compressions and 2 breaths, and don't stop for longer than it takes to swap with someone.

The AED will tell you what to do out loud when it arrives. Bare chest, pads where the pictures show, everyone's hands off when it says to analyze. It will not shock someone who doesn't need it.

The reason we drill this in class is that reading it and doing it are different skills. Come push on a manikin until your arms are tired — that's the part that sticks.