What to do If someone is injured in an accident:
•First check that you and the casualty are not in any danger. If you are, make the situation safe.
•When it's safe to do so, dial 999 or 112 for an ambulance, if necessary.
•Carry out basic first aid. If someone is unconscious and breathing If a person is unconscious but is breathing and has no other life-threatening conditions, they should be placed in the recovery position until help arrives. If someone is unconscious and not breathing If a person is not breathing normally after an incident, call for an ambulance and then, if you can, start CPR straight away. Use hands-only CPR if you are not trained to perform rescue breaths. If someone is injured in an incident, first check that you and the casualty are not in any danger. If you are, make the situation safe. When it's safe to do so, assess the casualty and dial 999 or 112 for an ambulance (if necessary). You can then carry out basic first aid. Assessing a casualty The priorities when dealing with a casualty can be remembered as ABC:
•Airway
•Breathing
•Circulation
Airway If the casualty appears unresponsive, ask them loudly if they are OK and if they can open their eyes. If they respond, you can leave the casualty in the position they are in until help arrives. While you wait, keep checking their breathing, pulse and level of response: •Are they alert?
•Do they respond to your voice?
•Do they respond to pain?
•Is there no response to any stimulus (they're unconscious)? If there is no response, leave the casualty in the position they are in and open their airway. If this is not possible in the position they are in, gently lay them on their back and open the airway. You open the airway by placing one hand on the casualty’s forehead and gently tilting the head back, then lifting the tip of the chin using two fingers. This is to move the tongue away from the back of the mouth. Do not push on the floor of the mouth as this will cause the tongue to obstruct the airway. If you think they may have a spinal injury, place your hands on either side of their face and use your fingertips to gently lift the angle of the jaw to open the airway. Take care not to move the casualty’s neck. 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. •Feel their breath against your cheek for 10 seconds. If they are breathing, place them in the recovery position so the airway remains clear of obstructions. If the casualty is not breathing, call 999 or 112 for an ambulance, then begin CPR.
Circulation If the heart stops beating, you can help maintain their circulation by performing chest compressions. This is cardiopulmonary resuscitation (CPR) when combined with rescue breaths. If you are not trained or feel unable to give rescue breaths, you can perform compression-only CPR. 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 should not be mistaken for normal breathing and CPR should be given straight away. The recovery position 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 ensure their airway remains clear and open. It also ensures that any vomit or fluid will not cause them to choke. To place someone in the recovery position:
•kneel on the floor on one side of the person
•place the arm nearest you at a right angle to their body with their hand upwards towards the head
•tuck their other hand under the side of their head, so that the back of their hand is touching their cheek
•bend the knee farthest from you to a right angle •roll the person onto their side carefully by pulling on the bent knee
•the top arm should be supporting the head and the bottom arm will stop you rolling them too far
•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 breathing and pulse continuously until help arrives
•if their injuries allow you to, turn the person onto their other side after 30 minutes Spinal injury If you think a person may have a spinal injury, do not attempt to move them until the emergency services reach you, unless their airway is obstructed. If it is necessary to open their airway, place your hands on either side of their face 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 a head injury, especially one where there has been a large blow on the back of the head, and is or has been unconscious •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 •has a twisted neck or back If you must move the person (for example, because they are vomiting, choking or they are in danger of further injury), you will need assistance to roll them. How to put someone into the recovery position CPR Cardiopulmonary resuscitation (CPR) is a first aid technique that can be used if someone is not breathing properly or if their heart has stopped. Chest compressions and rescue breaths keep blood and oxygen circulating in the body. If someone is not breathing normally and is not moving or responding to you after an accident, call 999 or 112 for an ambulance. Then, if you can, start CPR straight away. Hands-only CPR If you have not been trained in CPR or are worried about giving mouth-to-mouth resuscitation to a stranger, you can do chest compression-only (or hands-only) CPR. To 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 5–6cm on their chest. •Repeat this until an ambulance arrives. Try to perform chest compressions at 100-120 chest compressions a minute. When you call for an ambulance, telephone systems now exist that can give basic life-saving instructions, including advice on CPR. These are now common and are easily accessible with mobile phones. CPR with rescue breaths If you’ve been trained in CPR, including rescue breaths, and feel confident using your skills, you should give chest compressions with rescue breaths. If you are not completely confident, attempt hands-only CPR instead (see above). Adults •Place the heel of your hand on the centre of the person's chest, then place the other hand on top and press down by 5–6cm at a steady rate, at approximately 100 compressions per minute. •After every 30 chest compressions, give two breaths.
•Tilt the casualty's head gently and lift the chin up with two fingers. Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth. Check that their chest rises. Give two rescue breaths. •Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives. Children over one year old
•Open the child's airway by placing one hand on the child’s 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 five initial rescue breaths.
•Place the heel of your hand on the centre of their chest and press down by at least one-third of the depth of the chest. Use two hands if you can't press down hard enough with one.
•After every 30 chest compressions at a rate of 100 per minute, give two breaths.
•Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives. Babies under one year old
•Open the baby's airway by placing one 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 five initial rescue breaths.
•Place two fingers in the middle of the chest and press down by one-third of the depth of the chest. Use the heel of one hand if you cannot press deep enough with two fingers.
•After 30 chest compressions at a rate of 100 per minute, give two breaths.
•Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives. Read more information about how to resuscitate a child.
Cardiopulmonary resuscitation (CPR) is a first aid technique that can be used if someone is not breathing properly or if their heart has stopped.
Chest compressions and rescue breaths keep blood and oxygen circulating in the body.
If someone is not breathing normally and is not moving or responding to you after an accident, call 999 or 112 for an ambulance. Then, if you can, start CPR straight away.
If you have not been trained in CPR or are worried about giving mouth-to-mouth resuscitation to a stranger, you can do chest compression-only (or hands-only) CPR.
To carry out a chest compression:
Try to perform chest compressions at 100-120 chest compressions a minute.
When you call for an ambulance, telephone systems now exist that can give basic life-saving instructions, including advice on CPR. These are now common and are easily accessible with mobile phones.
If you’ve been trained in CPR, including rescue breaths, and feel confident using your skills, you should give chest compressions with rescue breaths. If you are not completely confident, attempt hands-only CPR instead (see above).
Read more information about how to resuscitate a child.
Step 1 of 5: Open their airway• If they are unconscious, open their airway.• Place one hand on the casualty’s forehead and two fingers under their chin. Gently tilt their head back and lift the chin.
Step 2 of 5: Check their breathingMaintain the head tilt and chin lift, and look for chest movement. Listen for the sounds of normal breathing and see if you can feel their breaths on your cheek.If they are not breathing, you need to start CPR (cardiopulmonary resuscitation – a combination of chest pressure and rescue breaths) straight away.
Step 3 of 5: Call for help and start CPRCall 999 or 112 for an ambulance, or get someone else to do it.Next you’ll need to perform CPR - cardiopulmonary resuscitation. This involves giving someone chest compressions and rescue breaths to keep their heart and circulation going.If they start breathing normally again, stop CPR and put them in the recovery position.
Step 4 of 5: Giving chest compressions• Kneel down beside the casualty on the floor level with their chest.• Place the heel of one hand towards the end of their breastbone, in the centre of their chest.• Place the heel of your other hand on top of the first hand and interlock your fingers, making sure you keep the fingers off the ribs.• Lean over the casualty, with your arms straight, pressing down vertically on the breastbone, and press the chest down by 5-6cm (2-2½in).• Release the pressure without removing your hands from their chest. Allow the chest to come back up fully – this is one compression.Repeat 30 times, at a rate of about twice a second or the speed of the song ‘Staying Alive’.Give two rescue breaths.
Step 5 of 5: How to give a rescue breath• Ensure the casualty’s airway is open.• Pinch their nose firmly closed.• Take a deep breath and seal your lips around their mouth.• Blow into the mouth until the chest rises.• Remove your mouth and allow the chest to fall.Repeat once more.Carry on giving 30 chest compressions followed by two rescue breaths for as long as you can, or until help arrives.If the casualty starts breathing normally again, stop CPR and put them in the recovery position.
