Emergency Aid

Getting an Overview and Staying Safe

Before providing first aid, make sure it's safe to approach. Look out for possible dangers such as traffic, fire, gas leaks or unstable structures. Your own safety always comes first. After all, getting injured yourself won't help anyone.

Once it's safe, try to get an overview of what has happened and how many people are involved. If several people need assistance, you may have to decide who needs help most urgently. Don't hesitate to ask bystanders for help.

Initial Assessment and Emergency Call

Check whether the person responds when you speak to them and gently touch their shoulders. If they're unresponsive, seriously injured or showing signs of a medical emergency, call your local emergency number immediately. You can also ask someone nearby to make the call while you help. Put the phone on speaker and follow the dispatcher's instructions.

If the person is unresponsive, open their airway and check whether they're breathing normally. This should take no longer than 10 seconds.

If they're unconscious but breathing normally, keep their airway open and place them in the recovery position when appropriate. If a serious accident or possible spinal injury is involved, avoid unnecessary movement unless it's needed to maintain their airway. Continue monitoring their breathing until help arrives.

If the person is unresponsive and isn't breathing normally, even if they're occasionally gasping for air, begin CPR immediately. Gasping isn't normal breathing, and trying to find a pulse can waste valuable time. If an AED is available, have someone bring it while you begin resuscitation.

Severe bleeding also requires immediate action. Apply firm, direct pressure to the wound and make sure emergency services have been called.

Once you've dealt with the most urgent problems, you can use the following assessment schemes to examine the person's condition more systematically. ABCDE helps identify potentially life-threatening problems, while SAMPLE helps collect useful information about the person and what happened. Neither should delay urgent lifesaving measures.

The ABCDE Schema

The ABCDE schema is a structured way to assess someone who is seriously ill or injured. It helps first aiders look for important problems in a sensible order, especially when it's difficult to know where to start. The letters stand for Airway, Breathing, Circulation, Disability and Exposure.

The steps aren't a rigid checklist that has to be finished before taking action. If you notice life-threatening bleeding, stop it immediately. If someone is unresponsive and isn't breathing normally, start CPR rather than continuing through the alphabet.

Airway:
First, make sure air can pass into the person's lungs. In an unconscious person, the tongue can fall backwards and obstruct the airway. Tilting the head back and lifting the chin can help open it. If a neck injury is suspected, minimize unnecessary movement and follow the emergency dispatcher's instructions, but remember that keeping the airway open takes priority. Never blindly reach into someone's mouth to look for an obstruction. Only remove an object if you can clearly see it and reach it safely.

Breathing:
Check whether the person is breathing normally by looking for chest movements and listening and feeling for breathing. This should take no longer than 10 seconds. Occasional gasps do not count as normal breathing. If the person is unresponsive and isn't breathing normally, begin CPR immediately and follow the dispatcher's instructions.

Circulation:
Look for signs of poor circulation, such as pale or clammy skin, severe weakness, dizziness or unusual confusion. Pay particular attention to heavy bleeding, which can become life-threatening very quickly. Apply firm, direct pressure to a bleeding wound. Someone without medical training shouldn't waste valuable time trying to find a pulse, especially when cardiac arrest is suspected.

Disability:
This step focuses on the nervous system. Check whether the person is alert, confused or responding normally when spoken to. Sudden changes in consciousness, difficulty speaking, weakness on one side of the body or seizures can indicate a serious medical problem. These signs should be reported to emergency services.

Exposure:
Finally, check for injuries that might not be obvious at first, such as bleeding, burns, swelling or signs that the person is becoming too cold or overheated. Move clothing only as much as necessary to examine an injury. Keep the person warm and respect their privacy.

ABCDE is useful for noticing urgent problems and reassessing someone while waiting for help. If the person is conscious and able to talk, you can then use the SAMPLE schema to collect information that might be helpful to the emergency team.

The SAMPLE Schema

SAMPLE is a simple way to remember which details may be important during a medical emergency. You don't need to conduct a formal interview. If the person is stable enough to speak, a few relevant details can help emergency personnel understand what has happened. Talking calmly with the person may also help reassure them.

Signs and Symptoms:
Find out what the person is experiencing and notice any visible signs of illness or injury. Pain, breathing difficulties, dizziness, swelling and changes in behaviour can all provide useful clues. If the symptoms started suddenly, try to remember or note when they began.

Allergies:
Ask whether the person has any known allergies, especially to medications, foods or insect stings. This information can be important if an allergic reaction is involved or medical treatment is needed.

Medications:
Find out whether the person takes any medication regularly or has recently taken something. Prescription medicines, over-the-counter products and supplements can all be relevant. If possible, keep the medication packaging available for the emergency team.

Past medical history:
Existing conditions such as diabetes, heart disease, asthma or epilepsy may help explain the emergency. Previous serious illnesses, operations or similar episodes can also be worth mentioning.

Last oral intake:
Note when the person last ate or drank, particularly if they have diabetes, feel faint or may need urgent treatment. This is information for the emergency team, not a reason to give someone food or water. Never give anything by mouth to an unconscious person.

Events prior to incident:
Find out what the person was doing when the symptoms began. A fall, physical exertion, a recent meal, medication or a sudden illness may all be relevant. Sometimes another person who witnessed the event can provide information that the patient cannot.

Of course, not every emergency leaves enough time for a conversation. ABCDE and SAMPLE are there to help organize what you notice, not to slow you down. Some conditions need immediate action as soon as you recognize the warning signs.

Heart Attack

What Happens During a Heart Attack?
A heart attack occurs when blood flow to part of the heart muscle is suddenly reduced or blocked. This usually happens when a blood clot forms in a coronary artery, often at the site of a ruptured atherosclerotic plaque. Without enough oxygen, the affected heart muscle can become permanently damaged.

Heart attacks become more common with age, but they can also affect younger adults. Smoking, high blood pressure, elevated LDL cholesterol, diabetes and a family history of cardiovascular disease are among the important risk factors.

Recognizing a Heart Attack:
A common warning sign is pressure, tightness or pain in the chest that lasts for several minutes or comes and goes. The discomfort may spread to the arm, back, neck, jaw or upper abdomen. Shortness of breath, nausea, sweating, dizziness and unusual weakness can also occur. Not everyone experiences the classic severe chest pain, so less typical symptoms shouldn't simply be dismissed.

First Aid for a Heart Attack:
Call your local emergency number immediately if a heart attack is suspected. Help the person sit or lie in a comfortable position, keep them calm and avoid unnecessary physical activity. Stay with them and monitor their condition. Follow the dispatcher's advice about medication, including whether aspirin is appropriate for a conscious adult. Don't give medication without considering allergies or other contraindications.

If the person becomes unresponsive and stops breathing normally, begin CPR and use an AED as soon as possible.

Stroke

What Happens During a Stroke?
A stroke occurs when part of the brain suddenly loses its normal blood supply. Most strokes are caused by a blocked blood vessel, but some are caused by bleeding in or around the brain. In either case, brain cells can be damaged very quickly.

The risk increases with factors such as high blood pressure, smoking, diabetes, atrial fibrillation and age. But strokes can occur in younger people too.

Recognizing a Stroke with BE-FAST:
Stroke symptoms often appear suddenly. They can include weakness on one side of the body, difficulty speaking, visual disturbances, loss of balance or a severe headache without an obvious explanation. The BE-FAST schema helps you remember some of the most important warning signs.

First Aid for a Stroke:
Call emergency services immediately. Keep the person comfortable and don't let them drive themselves to hospital. Avoid giving food, drinks or medication unless emergency professionals specifically instruct you to do so. Monitor their breathing and responsiveness while waiting for help.

Even if the symptoms disappear after a few minutes, urgent medical assessment is still necessary. This can be a transient ischemic attack (TIA), which may be a warning sign of a future stroke.

Trauma-related Emergencies

What are Trauma-related Emergencies?
Trauma-related emergencies include serious injuries caused by falls, road accidents, cuts, burns and other physical events. As with any emergency, make sure the scene is safe before approaching. Remember the initial assessment: Life-threatening bleeding and the absence of normal breathing need attention before less urgent injuries.

Heavy Bleeding:
For severe bleeding, call your local emergency number and apply firm, continuous pressure directly to the wound using a dressing or clean cloth. Once the bleeding is controlled, a pressure dressing may help maintain that pressure. If a life-threatening bleed from an arm or leg cannot be controlled with direct pressure, a properly applied commercial tourniquet may be necessary. Follow your training and the emergency dispatcher's instructions. A tourniquet must not be loosened by a first aider once applied.

Foreign Objects in a Wound:
If an object is deeply embedded in the body, don't pull it out. Removing it could make the bleeding or injury worse. Instead, avoid moving the object and apply padding or dressings around it. If the wound is bleeding, apply pressure around the object rather than directly on top of it.

Severed Body Parts:
First, control any severe bleeding and call for help. If a body part has been severed, wrap it in a clean cloth or sterile dressing lightly moistened with water or saline. Place it in a sealed, waterproof bag or container, then put that container into another bag or container with ice or cold water. The body part should stay cool without touching ice directly or freezing. Make sure it goes to the hospital with the injured person.

Burns and Scalds:
Cool a fresh thermal burn under cool running water for about 20 minutes when practical. Don't use ice, butter or greasy home remedies. Keep the rest of the person warm, especially if the burn covers a large area. Remove jewellery or loose clothing near the burn if it isn't stuck to the skin, then cover the area loosely with a clean, non-stick dressing. Deep or extensive burns, electrical burns and chemical burns need prompt medical assessment. Make sure an electrical source is disconnected before approaching an injured person.

Fractures and Possible Spinal Injuries:
Support an injured arm or leg in the position you find it and avoid unnecessary movement. Don't try to straighten a visibly deformed limb or pull on a broken leg. After a serious fall or road accident, a neck or spinal injury may also be possible. Encourage a conscious person to keep their head and neck still until help arrives. Untrained first aiders shouldn't try to fit a cervical collar. If the person is unresponsive, maintaining the airway and providing lifesaving care still take priority.

Whatever caused the emergency, the situation can change while you're waiting for help. Someone who was initially conscious may suddenly collapse. That's why it is important to keep checking whether they respond and breathe normally.

Cardiac Arrest

What Is Cardiac Arrest?
Cardiac arrest happens when the heart suddenly stops pumping blood effectively. The person becomes unresponsive and normally stops breathing, although they may still make occasional gasping movements. Without immediate help, the brain and other organs are deprived of oxygen.

The most important steps are to recognize the problem, call emergency services, start CPR and use an AED as soon as possible. CPR keeps some blood flowing until the heart can be treated. An AED analyzes the heart rhythm and can deliver a shock when one is needed.

Call for Help:
If someone is unresponsive and isn't breathing normally, call your local emergency number immediately and put your phone on speaker. If other people are present, ask one person to call and another to bring an AED. Follow the emergency dispatcher's instructions while starting CPR.

Start Chest Compressions:
Kneel beside the person and place the heel of one hand in the centre of the chest, on the lower half of the breastbone. Place your other hand on top, keep your arms straight and push down firmly. For an adult, aim for 100 to 120 compressions per minute, about 5 to 6 cm deep. Allow the chest to rise fully between compressions and keep interruptions as short as possible.

• CPR for adolescents and adults:
  If you've learned how to give rescue breaths and are willing to do so, use 30 chest compressions followed by 2 rescue breaths. Each breath should be enough to make the chest rise. If you haven't been trained or can't give rescue breaths, continue chest compressions without stopping. Don't let uncertainty about the breathing technique prevent you from helping.

• CPR for children and babies:
  For children and infants, cardiac arrest is often related to a breathing problem, which makes rescue breaths particularly important. If you can give them, start with five initial rescue breaths and then continue CPR. People without specific paediatric CPR training can use a ratio of 30 compressions to two breaths, while those trained in paediatric basic life support generally use 15 compressions to two breaths. Compression depth is about one-third of the chest, and the hand technique depends on the child's age and size. For infants, current European guidance recommends a two-thumb technique with the hands encircling the chest. Follow the dispatcher and the skills taught in a current paediatric first-aid course. If you can't give breaths, perform chest compressions rather than doing nothing.

Using an Automated External Defibrillator (AED):
Switch on the AED as soon as it arrives and follow its spoken and illustrated instructions. Apply the pads as shown on the device. Nobody should touch the person while the AED is analyzing the rhythm or delivering a shock. Resume CPR immediately when instructed. AEDs can also be used for children, with paediatric pads or settings when available. Don't delay using an AED because you're worried about operating it incorrectly. The device will guide you through the process.

Keep Going:
Continue CPR until emergency professionals take over or tell you to stop, the person clearly regains responsiveness and normal breathing, or you're physically unable to continue safely. If another person can help, take turns performing chest compressions so their quality doesn't deteriorate through exhaustion.

Closing Words

Nobody expects to end up in a situation where someone suddenly needs first aid. But it can happen to any of us, and knowing a few basic steps can make a real difference until professional help arrives.

This article is meant as an overview and a reminder, not as a replacement for practical training. A first-aid course gives you the chance to practise CPR, using an AED and dealing with injuries before you ever have to do it in a real emergency. Refreshing those skills every now and then is well worth it.

Update Status:
Originally created post: 07/2013
Last updated: 09/2026