Heart Attack Symptoms and Response Toolbox Talk

A heart attack can happen on any jobsite and may not always look like sudden collapse. A worker may have chest pressure, shortness of breath, sweating, nausea, weakness, dizziness, or pain spreading to the arm, back, neck, jaw, or shoulder. Heat, heavy lifting, stress, fatigue, and ignoring symptoms can make the situation worse.

This talk focuses on recognizing heart attack warning signs, calling emergency services quickly, keeping the worker still, and supporting trained first aid, CPR, and AED responders until help arrives.

Why This Matters

• Heart attack symptoms can get worse quickly and may lead to cardiac arrest.
• Workers may try to push through symptoms because they think it is heartburn, heat stress, soreness, or fatigue.
• Fast medical response can improve the worker’s chance of survival and recovery.
• CPR and AED use may be needed if the worker becomes unresponsive or stops breathing normally.
• Clear directions help emergency responders reach the worker without delay.

Common Hazards

• Chest pain, tightness, pressure, squeezing, or discomfort that does not go away.
• Pain or discomfort spreading to the arm, shoulder, back, neck, jaw, or stomach.
• Shortness of breath, sweating, nausea, vomiting, dizziness, weakness, or feeling faint.
• A worker becoming pale, cold, clammy, confused, unusually tired, or unable to continue the task.
• Heavy exertion, heat, cold, stress, dehydration, long shifts, or high-demand work triggering symptoms.
• Workers driving themselves or being driven by coworkers instead of waiting for emergency responders.
• A worker sitting down during a break with mild symptoms that suddenly worsen or turn into collapse.

Safety Checklist

Before Work Begins

• Know who on the crew is trained in first aid, CPR, and AED use.
• Locate the nearest AED, first aid kit, phone, radio, emergency contact list, and site address.
• Confirm the best gate, access road, or entry point for emergency responders.
• Review how to stop work, clear the area, and guide responders to the worker.
• Remind workers to report chest pain, breathing trouble, dizziness, unusual sweating, or unexplained weakness right away.

During Work

• Stop work and call emergency services immediately if a worker shows heart attack symptoms.
• Have the worker sit or lie in a comfortable position and keep them as calm and still as possible.
• Do not let the worker walk around, climb down alone, drive, or return to work.
• Send someone to get the AED and another person to meet emergency responders at the gate.
• Have trained workers provide first aid, CPR, and AED use within their training if the worker becomes unresponsive or is not breathing normally.
• Do not give food, drink, or medication unless directed by emergency services or medical professionals.
• Track symptoms, time they started, changes in condition, and any first aid provided so responders can be briefed.

Crew Talking Points

• What heart attack symptoms should the crew report immediately?
• Who on this crew is trained in first aid, CPR, and AED use?
• Where is the closest AED, first aid kit, phone, radio, and emergency contact list?
• How will emergency responders reach today’s work area?
• What should workers do if symptoms happen while someone is on a roof, lift, scaffold, trench, or remote area?
• Speak up if you are unsure where the AED is, who is trained, or how to get responders to the work area quickly.

Stop Work If

• A worker has chest pain, pressure, shortness of breath, sweating, nausea, dizziness, weakness, or pain spreading to the arm, back, neck, jaw, or shoulder.
• A worker collapses, becomes unresponsive, or is not breathing normally.
• The AED, phone, radio, emergency contact list, or access route is missing, blocked, or not working.
• The worker is in a location where they cannot be safely reached by responders without stopping nearby work.
• The crew is unsure whether symptoms are serious and the condition could get worse.

Final Reminder

Do not wait to see if heart attack symptoms pass. Stop work, call emergency services, keep the worker still, get the AED, and be ready to start CPR if trained.