How to run a cardiac arrest simulation drill at work

A first aid training session delivers solid knowledge about calling for help, chest compressions, and using an automated external defibrillator. It leaves little room, however, for the real stress of a moment when a colleague collapses without warning and several people look at each other, unsure who should act first. This brief but very real freeze explains why precious minutes can slip away before the first actions begin.

The simulation drill fills that gap between theory and action. By recreating a believable scene, with one person playing the victim and colleagues reacting as they truly would, the organisation can see exactly where hesitation creeps in: how easily the defibrillator can be reached from the workstation involved, how fast someone thinks to ask a bystander to call emergency services, or the order in which actions follow once chest compressions start. These points are only fixed properly after being seen once in practice.

A successful drill is prepared in advance, led by someone who already knows first aid, whether a designated first aider or simply someone recently trained. The location is chosen to match the real site: a busy corridor, a locker room, a break room, an isolated post at the far end of a building. The scenario stays simple, with no dramatic staging, so it remains close to something plausible in that exact setting.

Mock equipment avoids any confusion with the real thing: a training defibrillator, with no electrodes or active battery, or, failing that, the real unit clearly announced as being used for a dry run before the drill starts. Letting people on site know in advance, even without revealing the scenario, reduces the risk of a bystander outside the drill genuinely calling emergency services, believing it to be a real emergency.

Assigning clear roles before starting the drill avoids general improvisation and allows each function to be observed separately. The simulated victim stays passive once the drill is under way, neither helping nor hindering the group. The first bystander spots the situation and raises the alarm, while a second rescuer fetches the defibrillator as chest compressions begin. Someone outside the scene, tasked with observing and timing, gathers material for the debrief that follows.

The drill begins without telling participants the exact time, as far as the site's organisation allows, to come closer to a spontaneous reaction rather than a rehearsed one. The simulated victim collapses, the first bystander reacts based on what they retained from training, and the rest of the group organises around them without further instruction from the facilitator.

The facilitator lets the scene play out without stepping in, except in case of a genuinely risky action, such as mistaking the mock equipment for a real, connected unit. Once chest compressions are under way and the simulated defibrillator is in place, the drill stops: there is no need to act out the arrival of emergency services in full for the learning to be complete.

The drill itself matters less than the discussion that follows. The debrief goes back over the sequence minute by minute: the time elapsed before the alarm, where the defibrillator was found, how clear the instructions were for the person who called emergency services. Everyone can share what they felt, including that initial freeze, without judgment on their reactions.

This step turns the drill into concrete improvements for the site: moving the defibrillator if access proved too slow, reviewing signage if no one knew where to look, or simply reassuring a participant about an action they thought they had performed incorrectly when it actually matched what is taught in training. The drill's summary can also feed into the site's safety register.

A single drill leaves a strong impression at the time, but its effect fades if nothing renews it. Aligning it with the pace of first aid training refreshers, or with staff turnover in the teams concerned, helps maintain a consistent level of reaction without multiplying the occasions that interrupt the site's activity.

Varying the location and scenario from one session to the next, rather than repeating the same situation every time, helps test access to the defibrillator from several points in the building. In a site with several posts or several buildings, this rotation ensures that the reaction observed on a given day does not depend solely on the team most used to the exercise.