Emergency First Aid

Every year in the UK, thousands of people die or are seriously injured in incidents. Many deaths could be prevented if first aid was given before emergency services arrive. What to do If someone is injured, you should:

First check that you and the casualty aren't in any danger, and, if possible, make the situation safe if necessary, dial 999 or 112 for an ambulance when it's safe to do so carry out basic first aid If someone is injured in an incident. If you are, make the situation safe. Assessing a casualty. The 3 priorities when dealing with a casualty are commonly referred to as ABC, which stands for:

Airway
Breathing
Circulation

Airway. If the casualty appears unresponsive, ask them loudly if they're OK and if they can open their eyes. If they respond, you can leave them in the position they're in until help arrives. While you wait, keep checking their breathing, pulse and level response:

Are they alert?
Do they respond to your voice?
Is there no response to any stimulus (are they unconscious)?

If there's no response, leave the casualty in the position they're in and open their airway.If this isn't possible in the position they're in, gently lay them on their back and open their airway.To open the airway, place 1 hand on the casualty's forehead and gently tilt their head back, lifting the tip of the chin using 2 fingers. This moves the tongue away from the back of the throat. Don't push on the floor of the mouth, as this will push the tongue upwards and obstruct the airway. If you think the person may have a spinal injury, place your hands on either side of their head and use your fingertips to gently lift the angle of the jaw forward and upwards, without moving the head, to open the airway. Take care not to move the casualty's neck. But opening the airway takes priority over a neck injury. This is known as the jaw thrust technique.

Breathing. To check if a person is still breathing: look to see if their chest is rising and falling listen over their mouth and nose for breathing sounds feel their breath against your cheek for 10 seconds. If they're breathing normally, place them in the recovery position so their airway remains clear of obstructions, and continue to monitor normal breathing.Gasping or irregular breathing is not normal breathing.If the casualty isn't breathing, call 999 or 112 for an ambulance and then begin CPR.

If the casualty isn't breathing normally, you must start chest compressions immediately. Agonal breathing is common in the first few minutes after a sudden cardiac arrest (when the heart stops beating).Agonal breathing is sudden, irregular gasps of breath. This shouldn't be mistaken for normal breathing and CPR should be given straight away. Hands-only CPRTo carry out a chest compression:Place the heel of your hand on the breastbone at the centre of the person's chest. Place your other hand on top of your first hand and interlock your fingers. Position yourself with your shoulders above your hands.

Using your body weight (not just your arms), press straight down by 5 to 6cm (2 to 2.5 inches) on their chest.

Keeping your hands on their chest, release the compression and allow the chest to return to its original position.

Repeat these compressions at a rate of 100 to 120 times a minute until an ambulance arrives or you become exhausted.

When you call for an ambulance, telephone systems now exist that can give basic life-saving instructions.

Coronavirus (COVID-19) adviceIf there's a chance the person who's unwell has coronavirus (COVID-19), place a cloth or towel over their mouth and nose and do hands-only CPR until an ambulance arrives.CPR with rescue breathsIf you have been trained in CPR, including rescue breaths, and feel confident using your skills, you should give chest compressions with rescue breaths. If you're not completely confident, attempt hands-only CPR instead.AdultsPlace the heel of your hand on the centre of the person's chest, then place the other hand on top and press down by 5 to 6cm (2 to 2.5 inches) at a steady rate of 100 to 120 compressions a minute. After every 30 chest compressions, give 2 rescue breaths.

Tilt the casualty's head gently and lift the chin up with 2 fingers. Pinch the person's nose. Seal your mouth over their mouth, and blow steadily and firmly into their mouth for about 1 second. Check that their chest rises. Give 2 rescue breaths.

Continue with cycles of 30 chest compressions and 2 rescue breaths until they begin to recover or emergency help arrives. Children over 1 year oldOpen the child's airway by placing 1 hand on their forehead and gently tilting their head back and lifting the chin. Remove any visible obstructions from the mouth and nose.

Pinch their nose. Seal your mouth over their mouth, and blow steadily and firmly into their mouth, checking that their chest rises. Give 5 initial rescue breaths.

Place the heel of 1 hand on the centre of their chest and push down by 5cm (about 2 inches), which is approximately one-third of the chest diameter. The quality (depth) of chest compressions is very important. Use 2 hands if you can't achieve a depth of 5cm using 1 hand.

After every 30 chest compressions at a rate of 100 to 120 a minute, give 2 breaths. Continue with cycles of 30 chest compressions and 2 rescue breaths until they begin to recover or emergency help arrives. Infants under 1 year oldOpen the infant's airway by placing 1 hand on their forehead and gently tilting the head back and lifting the chin. Remove any visible obstructions from the mouth and nose.

Place your mouth over the mouth and nose of the infant and blow steadily and firmly into their mouth, checking that their chest rises. Give 5 initial rescue breaths.

Place 2 fingers in the middle of the chest and push down by 4cm (about 1.5 inches), which is approximately one-third of the chest diameter. The quality (depth) of chest compressions is very important. Use the heel of 1 hand if you can't achieve a depth of 4cm using the tips of 2 fingers.

After 30 chest compressions at a rate of 100 to 120 a minute, give 2 rescue breaths. Continue with cycles of 30 chest compressions and 2 rescue breaths until they begin to recover or emergency help arrives. If a person is unconscious but is breathing and has no other life-threatening conditions, they should be placed in the recovery position. Putting someone in the recovery position will keep their airway clear and open. It also ensures that any vomit or fluid won't cause them to choke. With the person lying on their back, kneel on the floor at their side.

Extend the arm nearest you at a right angle to their body with their palm facing up. Take their other arm and fold it so the back of their hand rests on the cheek closest to you, and hold it in place.

Use your free hand to bend the person's knee farthest from you to a right angle. Carefully roll the person onto their side by pulling on the bent knee.

Their bent arm should be supporting the head, and their extended arm will stop you rolling them too far.

Make sure their bent leg is at a right angle. Open their airway by gently tilting their head back and lifting their chin, and check that nothing is blocking their airway. Stay with the person and monitor their condition until help arrives.

Spinal injuryIf you think a person may have a spinal injury, do not attempt to move them until the emergency services reach you.If it's necessary to open their airway, place your hands on either side of their head and gently lift their jaw with your fingertips to open the airway. Take care not to move their neck.You should suspect a spinal injury if the person: has been involved in an incident that's directly affected their spine, such as a fall from height or being struck directly in the back complains of severe pain in their neck or back won't move their neck feels weak, numb or paralysed has lost control of their limbs, bladder or bowels.

If someone is unconscious and breathing If an adult is unconscious but breathing, and has no other injuries that would stop them being moved, place them in the recovery position until help arrives. Keep them under observation to ensure they continue to breathe normally. Drowning. If someone is in difficulty in water, don't enter the water unless it's safe to do so. Don't put yourself at risk.Once the person is on land, you need to check if they're breathing. Ask someone to call 999 for medical help.If they're not breathing, open the airway and give 5 initial rescue breaths before starting CPR.If the person is unconscious but still breathing, put them into the recovery position with their head lower than their body and call an ambulance immediately.Continue watching the patient to ensure they don't stop breathing and continue to breathe normally. Electric shock (domestic)If someone has had an electric shock, switch off the electrical current at the mains to break the contact between the person and the electrical supply.If you can't reach the mains supply:

Do not go near or touch the person until you're sure the electrical supply has been switched off.

Once the power supply has been switched off, and if the person isn't breathing, dial 999 or 112 to for an ambulance.

Afterwards, seek medical help.FracturesIt can be difficult to tell if a person has a broken bone or a joint, as opposed to a simple muscular injury. If you're in any doubt, treat the injury as a broken bone.If the person is unconscious or is bleeding heavily, these must be dealt with first by controlling the bleeding with direct pressure and performing CPR.If the person is conscious, prevent any further pain or damage by keeping the fracture as still as possible until you get them safely to hospital.Once you have done this, decide whether the best way to get them to hospital is by ambulance or car.If the pain isn't too severe, you could transport them to hospital by car. Get someone else to drive if possible so you can care for the casualty during the trip.But call 999 if:they're in a lot of pain and in need of strong painkilling medication – call an ambulance and do not move them it's obvious they have a broken leg – do not move them, but keep them in the position you found them in and call an ambulance you suspect they have injured or broken their back – call an ambulance and do not move them.

Do not give the casualty anything to eat or drink as they may need an anaesthetic (numbing medication) when they reach hospital. Heart attackThis is one of the most common life-threatening heart conditions in the UK.If you think someone is having or has had a heart attack, call 999 and then move them into a comfortable sitting position.Symptoms include:chest pain – the pain is usually located in the centre or left side of the chest and can feel like a sensation of pressure, tightness or squeezing pain in other parts of the body – it can feel as if the pain is travelling from the chest down 1 or both arms, or into the jaw, neck, back or abdomen (tummy)

Sit the person down and make them comfortable.If they're conscious, reassure them and ask them to take a 300mg aspirin tablet to chew slowly (unless you know they shouldn't take aspirin – for example, if they're under 16 or allergic to it).If the person has any medication for angina such as a spray or tablets, help them to take it.Monitor their vital signs, such as breathing, until help arrives.If the person deteriorates and becomes unconscious, open their airway check their breathing and, if necessary, start CPR. Call 999 to tell them the patient is now in cardiac arrest.Poisoning. This is potentially life threatening.Most cases of poisoning in the UK happen when a person has swallowed a toxic substance, such as bleach, taken an overdose of a prescription medication, or eaten wild plants and fungi. Alcohol poisening can cause similar symptoms.If you think someone has swallowed a poisonous substance, call 999 to get immediate medical help and advice.The effects of poisoning depend on the substance swallowed, but can include vomiting, loss of consciousness, pain or a burning sensation.The following advice is important:Find out what's been swallowed so you can tell the paramedic or doctor.

Do not give the person anything to eat or drink unless a healthcare professional advises you to.

Do not try to cause vomiting. Stay with the person, as their condition may get worse and they could become unconscious.

If the person becomes unconscious while you're waiting for help to arrive, check for breathing and, if necessary, perform CPR. Do not perform mouth-to-mouth resuscitation if the casualty's mouth or airway is contaminated with the poison.Do not leave them if they're unconscious: they could vomit. The vomit could then enter their lungs and make them choke.If they do vomit naturally, try to collect some of it for the ambulance crew – this may help identify the cause of the poisoning.If the patient is conscious and breathing normally, put them into the recovery position and keep checking they're breathing normally.ShockIn the case of a serious injury or illness, it's important to look out for signs of shock.Shock is a life-threatening condition that occurs when the circulatory system fails to provide enough oxygenated blood to the body and, as a result, deprives the vital organs of oxygen.This is usually the result of severe blood loss, but it can also occur after severe burns, severe vomiting, a heart attack, a bacterial infection, or a severe allergic reaction (anaphylaxis).The type of shock described here isn't the same as the emotional response of feeling shocked, which can also occur after an accident.Signs of shock include:pale, cold, clammy skin sweating rapid, shallow breathing weakness and dizziness feeling sick and possibly vomiting thirst yawning sighing Seek medical help immediately if you notice that someone has any of the above signs of shock.If they do, you should:call 999 as soon as possible and ask for an ambulance treat any obvious injuries lie the person down if their injuries allow you to and, if possible, raise and support their legs, use a coat or blanket to keep them warm do not give them anything to eat or drink give them lots of comfort and reassurance monitor the person – if they stop breathing, start CPR and call 999 StrokeThe FAST guide is the most important thing to remember when dealing with people who have had a stroke.The earlier they receive treatment, the better. Call for emergency medical help straight away.If you think a person has had a stroke, use the FAST guide:Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.

Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.

Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.

Time – it's time to dial 999 immediately if you notice any of these signs or symptoms. Getting help in an emergencyIn the UK, 999 has been the emergency services number for many years.But you can now also call 112 to get help, which is the single emergency telephone number for the EU.This number will give you access to the emergency services wherever you are in the EU.When you call 999 or 112, you'll be asked what service you need, as well as:your telephone number the address you're calling from a brief description of what's wrong with the casualty and whether they're bleeding, unconscious or not breathing The call handler may advise you on how to assist the casualty until help arrives.