The actions of a bystander immediately following an emergency significantly impact a person’s chance of survival. The “Chain of Survival” highlights how immediate recognition and intervention by ordinary people bridge the gap until first responders arrive. Learning simple, actionable steps initiates life-saving measures when every second counts, especially in cases of cardiac arrest or severe bleeding. This basic knowledge allows anyone to make a difference during an unexpected medical event.
Immediate Action: Activating Emergency Response
Before providing aid, assess the environment to ensure the safety of both the victim and yourself. This prevents the emergency from escalating into multiple casualties, such as in traffic accidents or electrical hazards. Once the scene is safe, immediately activate the emergency medical system by calling the local emergency number.
Provide the dispatcher with clear, concise, and detailed information, starting with your exact location. Clearly state the nature of the emergency, such as “severe car accident” or “unresponsive person,” and estimate the number of people injured. Do not hang up until the dispatcher tells you to, as they may provide pre-arrival instructions, like guiding you through CPR or bleeding control. If multiple bystanders are present, delegate the calling task to one specific person to ensure the call is made immediately.
Controlling Severe Hemorrhage
Uncontrolled external bleeding can lead to death quickly, making immediate hemorrhage control a top priority, sometimes even before addressing airway issues. The most effective first step is to apply firm, direct, and continuous pressure onto the wound using a clean cloth, sterile gauze, or your hand. Do not remove the material, even if it becomes soaked with blood; simply add more material on top.
If direct pressure fails to stop the blood loss from a limb injury, or if the bleeding is life-threatening, consider using a commercial or improvised tourniquet. Place the tourniquet high on the limb, two to three inches above the wound, but never directly over a joint. Tighten it aggressively until the arterial bleeding stops completely; this action is necessary to prevent fatal blood loss, though it will likely cause pain for the victim. For wounds where a tourniquet is not feasible, such as the torso or neck, firm, direct pressure remains the standard, and packing the wound with gauze helps apply internal pressure.
Clearing Airway Obstructions
A fully blocked airway prevents oxygen from reaching the lungs, requiring immediate intervention to dislodge the foreign object. For a conscious adult or child who cannot cough, speak, or breathe, stand behind them and deliver five sharp back blows between the shoulder blades. If this fails, proceed immediately to performing five abdominal thrusts, commonly known as the Heimlich maneuver.
To perform abdominal thrusts, wrap your arms around the person’s waist, placing a fist (thumb side in) just above the navel. Grasp the fist with your other hand and deliver quick, forceful inward and upward thrusts to create an artificial cough that expels the object. For infants under one year old, the procedure involves five back blows while the infant is facedown on your forearm, followed by five chest compressions if unsuccessful. If the victim of any age becomes unconscious, stop the thrusts or blows, immediately call for help, and begin Cardiopulmonary Resuscitation (CPR).
Initiating Cardiopulmonary Resuscitation and Defibrillation
If an adult suddenly collapses, is unresponsive, and is not breathing normally (perhaps only gasping), they are likely experiencing sudden cardiac arrest. Immediate high-quality chest compressions are crucial, as they manually circulate oxygenated blood to the brain and vital organs. Untrained bystanders should focus on hands-only CPR, which involves pushing hard and fast in the center of the person’s chest.
Position the heel of one hand in the middle of the chest, with the other hand placed on top, and push down at a rate of 100 to 120 compressions per minute. Compressions should be deep, aiming for a depth of about two inches, and interrupted as little as possible. If an Automated External Defibrillator (AED) is available nearby, retrieve and use it quickly. The AED is designed for public use and provides clear, spoken instructions on pad placement and whether an electrical shock is needed to restart the heart’s rhythm.