DRSABCD is a systematic sequence used in emergency first aid to manage a situation and respond to a collapsed or unresponsive person. This standardized procedure provides a clear action plan for initial assessment and life support until professional medical help arrives. The protocol is widely recognized and adopted by first responders and the public. It is designed to prioritize safety and ensure a consistent, effective approach to a medical emergency, guiding the rescuer from the moment they approach the scene through to active resuscitation.
Initial Assessment: Danger, Response, and Sending for Help
The process begins with the “D” for Danger, which is the initial step for rescuer and bystander safety. Before approaching an injured person, the rescuer must check the surrounding area for hazards like live wires, moving vehicles, or unstable structures. If the scene is unsafe, the rescuer should not proceed until the danger is removed or the patient is moved to a secure location.
Once the scene is safe, the rescuer moves to “R” for Response, assessing the patient’s level of consciousness. This check involves using voice and touch, asking simple questions like, “Can you hear me?” and gently squeezing the person’s shoulders. The standard method for this is the AVPU scale, which classifies the patient as Alert, responsive to Voice, responsive only to Pain, or completely Unresponsive.
If the person is unresponsive, the next step is “S” for Send for Help, which involves immediately calling emergency medical services. The rescuer should call the local emergency number or delegate this task to a specific bystander. It is also important to request that someone locate the nearest Automated External Defibrillator (AED) while the initial assessment continues. Securing professional help early is paramount.
Prioritizing Vitals: Airway and Breathing
The sequence transitions to intervention, starting with “A” for Airway. The rescuer must ensure the patient’s airway is open and unobstructed, as this takes precedence over other injuries. The recommended technique for opening the airway is the head tilt/chin lift maneuver, which moves the tongue away from the back of the throat. If a foreign object is visible, it should be cleared using fingers.
The rescuer then proceeds to “B” for Breathing, checking if the person is breathing normally. This is assessed using the “Look, Listen, Feel” method for no more than 10 seconds. The rescuer looks for chest rise and fall, listens for breath sounds, and feels for air movement. Slow, infrequent gasping or gurgling, known as agonal breathing, is not considered normal and should be treated the same as absent breathing. If the patient is not breathing normally, the immediate next step is to begin active resuscitation.
Active Resuscitation: CPR and Defibrillation
The “C” stands for Cardiopulmonary Resuscitation (CPR), which is required if the patient is unconscious and not breathing normally. CPR involves a cycle of chest compressions and rescue breaths to circulate oxygenated blood to the brain and other vital organs. High-quality compressions are delivered at a rate of 100 to 120 compressions per minute and must be deep, aiming for about 5 to 6 centimeters in an adult. The standard ratio for a single rescuer is 30 chest compressions followed by 2 rescue breaths. The compressions should be performed with the heel of one hand placed on the center of the chest, with the other hand interlaced on top.
The final step, “D” for Defibrillation, involves using an Automated External Defibrillator (AED) as soon as one becomes available. An AED is a portable device that delivers an electrical shock to a heart suffering from an abnormal rhythm, potentially restoring a normal heartbeat. The rescuer should attach the pads as directed by the device and follow the verbal prompts, which analyze the heart rhythm and advise if a shock is necessary. CPR should continue until the AED is ready for use, the patient becomes responsive, or medical professionals take over.