When a person collapses without warning, a moment of focused assessment must precede any direct intervention. This pause ensures the person attempting to help does not become a second casualty, which would complicate the emergency. Following a standardized protocol increases the chances of a positive outcome by ensuring critical steps are performed in the correct order. A bystander’s methodical response can significantly influence the person’s chances of survival, especially in cases of sudden cardiac arrest.
Prioritizing Scene Safety
The first action upon encountering a collapsed person is to scan the immediate surroundings to ensure personal safety and the safety of the victim. This primary survey for danger is the prerequisite for providing care. Hazards can include moving traffic, electrical wires, spilled chemicals, or a collapsing structure. If the environment presents an immediate danger, the individual must be moved only if necessary to save a life. Otherwise, the rescuer should not approach until the danger is removed. Identifying and mitigating risks prevents a single emergency from escalating.
Checking for Responsiveness and Activating Emergency Services
After confirming the scene is safe, the next step is to quickly determine the person’s level of consciousness. This is done by gently tapping the shoulder and shouting loudly, “Are you okay?” A person who responds verbally, moves, or opens their eyes is considered responsive. If there is no response, the person is unresponsive, signaling a severe medical emergency.
The rescuer or a designated bystander must immediately call the local emergency number, such as 9-1-1. Provide the dispatcher with the exact location and state that the person is unresponsive and collapsed. If other people are present, delegate one person to call emergency services and another to locate an Automated External Defibrillator (AED). Delegating tasks ensures the call is made quickly and allows the rescuer to remain with the patient.
Evaluating Breathing and Circulation
With emergency services alerted, the next step is a rapid assessment of the person’s breathing. Open the airway using the head-tilt, chin-lift maneuver, which involves tilting the forehead back while lifting the chin. This action moves the tongue away from the back of the throat, which is a common cause of airway obstruction. The rescuer then looks, listens, and feels for normal breathing for no more than 10 seconds.
Look for the chest to rise and fall, listen for air movement, and feel the breath to determine breathing status. Agonal gasps—infrequent, noisy, or labored breaths—should not be mistaken for normal breathing. Agonal gasps are a sign of cardiac arrest and should be treated as if the person is not breathing at all. For a lay rescuer, the traditional pulse check is eliminated from the protocol because it is unreliable and wastes time. If the person is unresponsive and not breathing normally, immediate action is necessary.
Initiating Support While Awaiting Help
The final steps involve providing immediate support based on the breathing assessment until professional help arrives. If the person is unresponsive but breathing normally, carefully place them into the recovery position. This position, typically on their side with the head tilted back, helps maintain an open airway and allows any fluid to drain from the mouth, preventing choking.
If the person is unresponsive and not breathing normally or is only gasping, immediately begin cardiopulmonary resuscitation (CPR). This involves pushing hard and fast on the center of the chest at a rate of 100 to 120 compressions per minute to manually circulate blood. If an Automated External Defibrillator (AED) arrives, apply it immediately and follow its voice prompts. Early defibrillation is the single most effective intervention for sudden cardiac arrest. Continue chest compressions without interruption until the AED advises a shock, the person shows signs of life, or trained medical personnel take over care.