A Whangārei father-of-five says he owes his life to two strangers who spotted the subtle signs his life was at risk in the city centre last Friday.
Louis Morunga, 56, said he could never truly express how grateful he was that chiropractor Dr Emma Rampton and St John ambulance officer Marleen Parata stopped him dying on Bank St in Whangārei.
"I owe these people my life. If it wasn't for them I wouldn't be here," the truck driver said. "Now I can build up to taking my mokopunas fishing for the first time like I had planned."
More people die from cardiac arrest than road crashes each year in New Zealand. About 15 per cent of people survive a cardiac arrest in the community.
Parata said Morunga's survival was a reminder of the role onlookers can play and the importance of businesses having a defibrillator (AED) at hand.
St John data shows bystander CPR and use of a defibrillator can increase a person's chance of survival by 50 per cent.
Morunga, from Hikurangi, had walked 15m up Bank St towards Inland Revenue after an appointment at the bank when he started to feel "puffed".
As he tried to pry the door of Inland Revenue open a dizzy sensation overcame him.
"The door wouldn't open. So before I kept going up the road I had a breather," Morunga said.
Rampton was walking into town from her workplace, the Mudgway Chiropractic Clinic. She spotted Morunga perched on the side of a raised planter box outside Inland Revenue.
"I don't know what made me stop," Rampton said. "He wasn't crying out for help or anything."
Concerned, she approached Morunga to ask if he was okay.
"That's when I noticed he was short of breath."
Her first aid training kicked in. She asked a flow of brief questions that concluded with her main thought: "Do you have a heart condition?"
Yes was the answer. Rampton probed further.
"He told me his chest was a little bit tight. He was chatting to me all breathless, like when you talk to someone who has just run to the top of a hill."
Rampton was getting set to phone for an ambulance when Morunga's condition took a dive.
"I'd been talking to him for half a minute and then I remember him looking at me as he fell sideways and hit the concrete."
Morunga landed between a pair of planter boxes, concealed from passersby.
"He could've been there a long time and no one could've realised," Rampton said.
She called to two blokes across the road to call an ambulance as she placed Morunga into the recovery position.
Off-duty St John ambulance officer Marleen Parata had also taken note of Morunga sitting "strangely" on the planter box from the car she was in.
She told her partner the situation seemed wrong and he pulled over.
"I just went with my gut feeling that something's not right. I hopped out of the car and ran over."
As Parata reached the duo she recognised Morunga was going into agonal breathing - struggling to breathe or gasping.
Agonal breathing is often a symptom of a severe medical emergency, such as stroke or cardiac arrest.
Morunga's skin had turned a "dreadful colour" as both his breathing and pulse ceased.
"I checked his pulse and thought, s*** he is having a heart attack," Rampton said. "I was really aware that every minute without a defib and CPR reduces your chances of survival."
The chances of survival drop by 10 to 15 per cent for every minute that goes by without CPR or defibrillation.
Parata started CPR until help arrived.
Her partner - also a St John ambulance officer – was at a nearby GP clinic gathering the help of a nurse and oxygen gear when his GoodSAM app went off.
GoodSAM alerts volunteers over 18, who have registered and are trained in CPR and defibrillation, to respond to nearby cardiac arrest emergencies.
Realising the person in distress was Morunga, two doctors and a nurse equipped with an AED rushed to Morunga's side.
Parata placed the AED pads on Morunga while another helper took over CPR.
"We did about five rounds of CPR but no shock was advised by the AED because he had no palpable pulse or shockable rhythm," Parata said.
Crews from the Whangārei Fire Station, local police, and St John ambulances from Bream Bay and Whangārei, as well as a rapid response unit with an intensive care paramedic all arrived on scene.
The enormity of the situation hit Rampton when she overheard a police officer talking about trying to contact Morunga's wife.
"I thought, this guy has a life and people who love him," she said.
Ambulance staff rushed Morunga to Whangārei Hospital in a critical condition.
About an hour later he roused in the Emergency Department.
"I was wondering where I was," Morunga said. "The first face I saw was my youngest son and I was wondering what he was doing there."
He said his 19-year-old son looked distraught.
Morunga was transferred to the Coronary Care Unit for treatment, where in the days following he said he was feeling "much better".
"I'm just lucky that everybody there knew what they were doing. If I had been at home in Hika I'd be bloody pushing the clouds around up there."
Rampton was overjoyed to learn Morunga had survived.
"There was somebody on his side that day. It was an amazing example of a community seeing a person in need and helping save the life of a total stranger."
Parata recommended everyone complete a St John first aid course to be prepared in an emergency.
Dr Tony Smith, St John clinical director, encouraged everyone to know the location of their nearest AED.
"Increasing the numbers of trained members of the public along with access to AEDs can better the odds for more than 2000 Kiwis who suffer a cardiac arrest each year."
To find your nearest AED visit: www.aedlocations.co.nz