Tabletop Tuesday: Edition 1 - Someone Just Collapsed in the Fitness Center

May 9

Here's something I've learned from years of managing buildings and running emergency exercises.

The scenarios that catch teams most off guard aren't fires or floods. They're the ones that feel rare until they're not. The medical emergency - the kind that moves fast, involves real human stakes, and requires a coordinated response from people who've never practiced it together - is the scenario most building teams are least prepared for.

Not because they don't care. Because it's uncomfortable to practice. Because it feels morbid to run a drill around a person in distress.

Here's what I believe strongly: the best emergency response doesn't happen during the emergency. It happens in the 45-minute exercise nobody wanted to find time in their busy week for.

Every experienced leader I know has a version of this story. The incident that went sideways. The vendor gap nobody knew existed. The communication failure that was entirely preventable. The decision that took 20 minutes because nobody had talked it through in advance.

Tabletop drills don't eliminate those moments. But they compress them from 20 minutes of real-time confusion into 3 minutes of practiced decision-making. That's the gap between a controlled incident and a chaotic one.

The teams that handle these well aren't calmer by nature. They've practiced the decisions before they needed to make them.

Welcome to Tabletop Tuesday - a recurring format where I drop a real building emergency scenario, walk through the decision framework, and surface the gaps that only show up when you actually try to answer the question.

This month: chest pains in the fitness center, a person in distress, and a building that needs to respond in the next several minutes. Work through it. Find the gaps. That's the entire point.

This month: Someone Just Collapsed in the Fitness Center

The Scenario

It's 11:23am on a Wednesday. Your fitness center coordinator calls your desk directly. A male, mid-50s, on the treadmill - stopped his machine, sat down on a bench, and told her he's having chest pains and feels lightheaded. He's conscious and talking but looks pale and is short of breath. He doesn't want to make a big deal of it. There are four other people in the gym. No other gym staff. The fitness center is on the 9th floor. The nearest AED is mounted on the wall outside the gym entrance. You do not know which company this tenant works for yet. The coordinator is waiting for you to tell her what to do. It has been approximately 5 minutes since he sat down.

What do you tell her in the next 20 seconds and what are you doing simultaneously?

The Five Decisions That Happen in the First Five Minutes

Medical emergencies move differently than building system failures. You're not waiting for an engineer's assessment. You're coordinating multiple people across multiple floors simultaneously - each with a specific role, while keeping the person calm and the situation controlled.

Here's what experienced leaders have pre-assigned before this call ever comes in.

Decision 1: Call 911 - When and Who?

The answer is immediately and the coordinator does it while you're still on the phone with her.

The instinct to wait - to assess whether it's "serious enough" - is the instinct that costs time. Chest pain in a middle-aged adult is a 911 call. The paramedics can stand down if it turns out to be minor. You cannot un-lose the minutes you spent deciding.

Tell the coordinator: "Call 911 right now. Stay on with them. Don't hang up until they tell you to. I'll handle everything else."

Then you handle everything else.

Decision 2: The AED - Who Gets It and When?

The AED is the most time-critical resource in a cardiac event. Brain damage begins within four to six minutes of cardiac arrest. Every minute without defibrillation reduces survival odds.

You need someone physically moving toward that AED before you know whether it will be needed.

Tell security or whoever is closest - to retrieve the AED from outside the gym entrance and bring it to the fitness center immediately. They don't wait for confirmation that it's needed. They move now.

This is why knowing where your AEDs are located before the call comes in is not optional. Walk your building. Find every AED. Note the floor, the location, who passes it on their daily route. That walk takes minutes and it matters enormously when seconds count.

Decision 3: The Elevator - Securing It for EMS

EMS needs direct, unobstructed access from the lobby to the fitness center floor. That means a dedicated elevator held at the ground floor, doors open, waiting.

Security gets on the radio or phone the moment 911 is called. One elevator is taken out of public service and positioned at the lobby level. No exceptions for tenants waiting. When the paramedics walk in the front door, the elevator is open and ready. And, any security turnstiles or related have been prepared for easy access for first responders.

Someone - security, lobby staff, a designated team member is stationed at the building entrance to meet EMS and walk them directly to the elevator. Not point them toward it. Walk them to it.

Decision 4: Who Stays With the Person?

The coordinator stays with the tenant. She is calm, she is talking to him, she is keeping him seated and still. She is not asking him to walk, not leaving him alone, not letting him downplay what's happening.

One bystander - calmly, specifically asked - retrieves the AED from the person security is bringing. You don't ask for volunteers generally. You make eye contact with a specific person and give them a specific task. "You - can you take that AED from security when they arrive and bring it over here?" Clear. Calm. Directed.

The other tenants in the gym are gently asked to give the person space. Not evacuated, not alarmed - just moved to the other side of the room with a brief explanation: "We want to give him some room while we wait for help."

Decision 5: Identifying the Tenant and Contacting HR

While EMS is en route, someone on your team is working on identification.

Name. Company. Floor. Emergency contact if available.

The tenant's HR contact needs to be notified - not after the ambulance leaves, but during the event, so they can locate an emergency contact, inform the appropriate people on their team, and be present or reachable when EMS arrives.

This is a conversation that should happen directly and professionally: "I'm the property manager. We have a medical situation involving one of your employees in the fitness center. EMS is on the way. Can you help us identify an emergency contact?"

Document the time of every call, every action, every person involved. Your incident log starts the moment the coordinator's call came in.

The Role Assignment - At a Glance

In a well-prepared building, these assignments exist before the incident. They're not improvised.

Coordinator / Gym Staff Calls 911. Stays with the tenant. Keeps them calm, seated, and still. Does not leave them alone.

Property Manager Coordinates all roles. Notifies security. Contacts tenant's HR. Manages documentation. Communicates with ownership after stabilization.

Security (or first available team member) Retrieves the AED and brings it to the fitness center. Secures one elevator at lobby level, doors open.

Lobby / Front Desk Stations at building entrance to physically meet and escort EMS to the elevator.

Designated Bystander Takes the AED from security and brings it to the coordinator. Calm, specific, task-oriented ask.

Five roles. Five people. None of them crossing over into each other's lane. The property manager's job is not to run to the gym - it's to make sure everyone else is moving and nothing falls through.

The Minute-by-Minute Framework

0:00–0:30 Coordinator calls you. You tell her to call 911 immediately and stay on the line. You begin calling security.

0:30–1:30 Security dispatches to retrieve AED. Second security or lobby staff positions at building entrance. Elevator secured at lobby level.

1:30–3:00 AED arrives at the fitness center. Coordinator has it ready. Tenant is seated, calm, talking. Other gym members have been gently moved.

3:00–5:00+ EMS enters the building. Lobby staff walks them to the elevator. Elevator goes directly to the floor. Your team steps back and gives EMS full access and information.

5:00+ You are managing documentation, tenant HR contact, ownership notification, and the lobby - not standing in the gym. EMS has command of the scene now.

The property manager's job shifts the moment EMS arrives. You are no longer coordinating the medical response. You are managing everything surrounding it - communication, documentation, access, and the people who don't yet know what's happening.

What This Drill Reveals About Your Building

Run this scenario with your full team - property management, security, lobby staff, and fitness center staff - in a room for 45 minutes. Here's what will surface.

Do you know exactly where every AED in your building is located? Not approximately - exactly. Can you tell a new security guard right now?
Has anyone on your team been trained to use the AED? Training takes 30 minutes. Most buildings have certified staff - many don't.
Does your security team know the elevator protocol for a medical emergency? Is there a specific elevator designated, or is it improvised each time?
Does your fitness center coordinator know to call 911 first - before calling you or do they call you and wait?
Do you have a process for identifying a tenant's company and HR contact quickly? Can you get that information in under five minutes during an active event?
Does your team know what to say to bystanders? "We want to give him some room while we wait for help" is a practiced line, not an improvised one.
What does your incident documentation look like in real time? A note app, a form, a call log? Whatever it is - is everyone using it or just hoping someone else is?

The tabletop doesn't have to be perfect. It has to surface the answers to those questions before the event does.

Including Your Fitness Center Staff - Not Optional

This scenario starts with your fitness center coordinator. Her decision in the first 90 seconds - whether to call 911 immediately, whether to keep the tenant calm and seated, whether to ask a bystander to retrieve the AED - has more impact on the outcome than anything your property management team does afterward.

Before the Drill - Two Things Worth Doing This Week

Walk the fitness center with the coordinator and go through the scenario out loud. Where is the AED? Have they ever used one? Do they know to call 911 before calling the property manager? Do they know not to let a tenant walk themselves to the elevator?

Ask about their current mindset. Some fitness center coordinators have been trained in CPR and AED use and feel confident. Others have been told to "call the front desk" and haven't thought beyond that. You need to know which one you have before the scenario becomes real.

Consider inviting gym staff to the next tabletop exercise directly. Not as a courtesy - because they are the first responder in this scenario and their decisions in the first 90 seconds shape everything that follows.

The Physical Drill Setup - Make It Real

This exercise works better when it feels real. Here's how to set it up in a way that actually changes how people respond.

Print the Floor Plans

Print the relevant floors - the fitness center floor and the lobby level. Lay them flat on a conference table. Use game pieces, sticky notes, or coins to represent your team members, the tenant, EMS, and the elevator.

Move the pieces as the scenario unfolds. This physical element forces the team to think spatially - where is security relative to the AED? How long does it actually take to walk from the lobby to the elevator bank? Where does the EMS team enter and which direction do they turn?

The floor plan makes abstract role assignments concrete. People stop saying "someone would get the elevator" and start saying "that's Marcus - he's at the lobby desk and the nearest elevator is twelve steps to his right."

Have the Emergency Action Plan on the Table

Not to read from it - to test it. Does your EAP cover medical emergencies specifically? Does it name who calls 911 or does it assume someone will figure it out? Does it have the AED locations listed?

The exercise will tell you whether your EAP reflects how your team actually operates. Most EAPs have not been tested this way.

Do a Physical Walkthrough First

Before the table exercise, walk the route. Start in the fitness center. Walk to the AED location. Walk to the elevator bank. Walk to the lobby entrance where EMS would arrive. Time it.

Most teams discover two things on this walk: the AED is further than they thought, and someone has put something in front of it.

The Debrief - Three Questions, Kept Simple

Within 24 hours of any real medical event and immediately after a tabletop drill - run a debrief. Keep it to 20 minutes and three questions only.

1. What worked? What did the team do well, what felt automatic, where was there clarity?

2. What slowed us down? Where was there hesitation, confusion about roles, missing information, or a gap in the process?

3. What do we need before next time? One to three specific, actionable changes - not a full policy rewrite. A change to the EAP. A new AED location note in the security handbook. A conversation with the gym staff. Assign an owner and a date.

The debrief after a real event follows the same format. It is not a blame exercise. It is a building exercise - you are building the protocol that makes the next event go better.

What's the first thing you'd do in this scenario?

If you found this newsletter interesting, consider checking out these past editions:

Matt Faupel