S.A.G.I.P.: Five steps that can guide bystanders during sudden cardiac arrest

The S.A.G.I.P. sequence presents five easy-to-remember actions—from checking the safety of the scene to performing chest compressions and using an automated external defibrillator.

Building on its flagship advocacy Sagip CPR, Bell-Kenz Pharma collaborated with Dr. Alexis Dimapilis, National Course Director for Basic Life Support (BLS) at the Department of Health, to develop S.A.G.I.P.—a five-step framework designed to help bystanders remember the immediate actions needed to perform Hands-Only Cardiopulmonary Resuscitation (CPR).

Sagip CPR aims to equip Filipinos with the knowledge and skills to perform Hands-Only CPR and respond to cardiac emergencies.

Since its launch last year, the advocacy has trained more than 50,000 Filipinos nationwide in more than 50 cities to recognize cardiac emergencies, perform Hands-Only CPR, and properly use an automated external defibrillator (AED).

These skills are especially critical when a person suddenly becomes unresponsive and stops breathing normally. During the crucial first minutes—before professional responders arrive—people already at the scene can become the first link in the chain of survival by recognizing the emergency, calling for help, and immediately beginning CPR.

However, the pressure of an emergency can make even basic instructions difficult to recall. S.A.G.I.P. organizes the response into five clear and memorable actions: Suriin, Alamin, Gamitin, Ilagay, at Paganahin.

The sequence is intended to help ordinary bystanders respond with greater confidence while calling for and awaiting appropriate emergency medical assistance.

Recognizing when action is needed

Before beginning CPR, a rescuer must first recognize the signs of possible sudden cardiac arrest. The module uses another simple reminder, U.N.N.A.: the person is Unresponsive or unconscious, is Not breathing or is breathing abnormally, and has No definite pulse when assessed by a healthcare provider - prompting Aksyon agad, or immediate action.

For a lay rescuer, the most important visible signs are that the person does not respond when called or gently tapped and is not breathing normally. Gasping should not be mistaken for normal breathing. Once these signs are present, the rescuer should call for emergency assistance, request an AED if one is available, and begin CPR.

S - Suriin ang Lugar

The first step is to check the surroundings. A rescuer should look for hazards such as moving traffic, fire, exposed electrical sources, unstable structures, or violence before approaching. This protects both the rescuer and the victim. Entering an unsafe scene can create another casualty and delay help for everyone involved.

A - Alamin ang Kalagayan ng Biktima

Once the area is safe, tap the person's shoulder, speak loudly and clearly, and check whether the person responds. Observe whether the person is breathing normally. If there is no response and breathing is absent or abnormal, treat the situation as an emergency and move immediately to the next steps.

G - Gamitin ang 911 o ang Lokal na Emergency Hotline

Call 911 or the local emergency hotline as soon as possible. If other people are present, give specific instructions: ask one person to contact emergency medical services and another to bring an AED. Clear assignments allow CPR and emergency activation to happen at the same time.

The caller should give the exact location, describe what happened, and follow the dispatcher's instructions. Emergency numbers and AED locations should be known before an incident occurs.

I - Ilagay ang Dalawang Kamay sa Gitna ng Dibdib at gawin ang Chest Compressions

Begin Hands-Only CPR by placing both hands at the centre of the chest on the lower part of the sternum. For an adult, compress the chest strongly and quickly at a rate of 100-120 compressions per minute and a depth of about 5-6 centimetres. Allow the chest to return fully after each compression and keep interruptions shorter than 10 seconds.

High-quality compressions help move blood to the brain and other vital organs. The module recommends 200-240 compressions over two minutes, followed by reassessment and continued CPR when the person remains unresponsive and is not breathing normally.

P - Paganahin ang Automated External Defibrillator

If an AED is available, turn it on, attach the pads as shown on the device, and follow its voice prompts. An AED automatically analyzes the heart rhythm and determines whether a shock is advised. It will not shock every patient, and a rescuer does not need to make that decision.

An AED supports CPR; it does not replace it. Resume compressions whenever instructed. Public-access AEDs may be found in airports, schools, restaurants, offices, public buildings, and other high-traffic locations.