The universally taught framework for responding to a medical emergency is the three emergency action steps: Check, Call, and Care. This sequence provides a simple, structured approach for bystanders to act swiftly and confidently when someone is ill or injured, serving as the foundational response before professional help arrives. Following these steps allows an ordinary person to manage the initial moments of an emergency and stabilize the situation.
Checking the Scene and the Injured Person
The initial step focuses on safety and rapid information gathering, beginning with a thorough assessment of the environment. Before approaching the individual, a rescuer must confirm the scene is safe to enter, checking for hazards like active traffic, fire, downed electrical wires, or unstable structures. Entering a dangerous environment can easily turn a single incident into a multiple-victim scenario, making personal safety the first priority.
Once the scene is safe, the rescuer can approach the individual to form an initial impression of the situation and the nature of the injury or illness. The first assessment involves checking for responsiveness by gently tapping the person and asking loudly, “Are you okay?”. If the person is unresponsive, the immediate action is to check rapidly for breathing and for any signs of severe, life-threatening external bleeding.
Breathing should be assessed by looking, listening, and feeling for normal respirations for no more than 10 seconds. Gasping or irregular breathing is not considered normal and requires immediate intervention. The rescuer must also look for catastrophic hemorrhage, which demands immediate attention, sometimes even before checking for breathing. The primary survey focuses only on identifying immediate, life-threatening conditions.
Calling for Professional Help
Activating the Emergency Medical Services (EMS) system is the second step, ensuring that advanced professional care is on the way as soon as a life-threatening condition is recognized. If a person is unresponsive, not breathing normally, or has other obvious life-threatening conditions, the call for help must be placed immediately. If multiple bystanders are present, the rescuer should delegate the task by pointing to a specific person and giving clear instructions, such as, “You, call 911 and tell them we have an unresponsive adult who is not breathing.”
When speaking with the dispatcher, remain calm and provide concise, accurate information. The dispatcher will need the precise location of the emergency, which may include a street address or landmarks. Crucial details about the nature of the emergency, the number of victims, and the condition of the injured person must be relayed quickly.
The dispatcher is trained to categorize the call based on priority, with non-breathing or severe trauma cases receiving the highest urgency. The rescuer should not hang up the phone until the dispatcher specifically instructs them to do so, as the operator can provide guidance for delivering care until paramedics arrive. This ongoing communication ensures the first responder is supported and can efficiently relay any changes in the victim’s status.
Delivering Immediate Care
The final step involves providing temporary, life-sustaining care until EMS personnel take over. Care priorities are determined by the initial assessment and focus on addressing the most immediate threats to life, such as compromised breathing or severe blood loss. For a non-breathing, unresponsive adult, high-quality cardiopulmonary resuscitation (CPR) should begin immediately, aiming for 100 to 120 compressions per minute.
If severe external bleeding is identified, controlling the hemorrhage is a time-sensitive intervention that prevents the victim from entering hypovolemic shock. Direct, firm pressure should be applied to the wound using a clean dressing or cloth to encourage clotting and slow blood loss. For extremity bleeding not controlled by pressure, or for catastrophic injuries, a tourniquet may be applied as a life-saving measure above the wound site.
For a conscious person with no immediate life-threats, care involves managing the injury, preventing the condition from deteriorating, and maintaining comfort. This includes stabilizing broken bones, providing care for burns, or assisting a person with a known medical condition, such as helping a diabetic person ingest sugar for suspected hypoglycemia. Positioning the victim appropriately is also important; for instance, an unconscious person who is breathing normally should be placed in the recovery position to maintain an open airway and prevent aspiration. The rescuer must continually monitor the victim for any changes until professional help assumes responsibility.