A medical emergency is a sudden, serious injury or illness that immediately threatens a person’s health and requires professional intervention without delay. The time between the incident and the arrival of professional help is often the most impactful in determining the outcome. Quick, decisive action by a bystander can significantly increase the chances of survival and minimize long-term disability. This guide provides a clear sequence of actions for immediate response until emergency medical services (EMS) take over.
Securing the Scene and Ensuring Rescuer Safety
The first step in any emergency is to assess the environment to protect yourself from harm. Quickly scan the immediate area for potential hazards like unstable traffic, downed electrical wires, hazardous materials, or violence. If the scene presents a clear danger, retreat to a safe distance and wait for trained personnel to secure the area before approaching the victim.
If the immediate environment is safe, you can approach the patient. Use personal protective equipment, such as disposable gloves, if available, especially when dealing with blood or bodily fluids. Moving the victim should only be done if their current location poses an immediate threat to life, such as being in a burning building or in the path of traffic. Unnecessary movement can worsen certain injuries, so maintain situational awareness.
Activating Emergency Medical Services
Once the scene is secure, the next immediate action is to activate the emergency response system, such as calling 911, or dispatching a bystander to do so. This is done immediately upon realizing the severity of the situation or confirming unresponsiveness. When speaking with the dispatcher, remain calm and communicate clearly to expedite the appropriate response.
Be prepared to provide precise information, starting with the exact location of the emergency, including the street address, cross streets, or specific landmarks. Clearly describe the nature of the emergency and the victim’s condition, such as whether they are breathing or have severe bleeding. Provide the number of people affected and a call-back number in case the connection is lost. Do not hang up the phone until the dispatcher instructs you to, as they may provide pre-arrival instructions for patient care.
Performing the Primary Assessment and Stabilizing Critical Threats
The primary assessment begins immediately after activating EMS and focuses on rapidly identifying and treating life-threatening conditions. For an unresponsive patient, this often follows the C-A-B sequence (Circulation, Airway, Breathing). Check for responsiveness by tapping the victim and shouting, “Are you all right?”. If the patient is unresponsive and not breathing normally, assume cardiac arrest and immediately begin chest compressions.
For an adult, hands-only cardiopulmonary resuscitation (CPR) involves pushing hard and fast in the center of the chest at a rate of 100 to 120 compressions per minute. The compression depth should be at least two inches, but no more than 2.4 inches, to effectively circulate oxygenated blood to the brain and vital organs. Minimizing interruptions to compressions helps maintain perfusion until advanced medical help arrives.
Simultaneously, or immediately after addressing CPR, check for and control any severe, life-threatening external bleeding. Uncontrolled hemorrhaging must be stopped immediately. The most direct intervention is to apply firm, direct pressure to the wound using a clean cloth or bandage. If direct pressure is insufficient and you are trained, a tourniquet can be applied to an extremity to stop the blood loss.
Secondary Care, Monitoring, and Handoff
Once immediate life threats are stabilized, or while waiting for EMS, continue to monitor the victim’s status, focusing on their level of consciousness and breathing. Keep the victim calm and still. Covering them with a blanket can help prevent hypothermia, which is a component of treating for shock. Do not attempt to give an unresponsive person anything to eat or drink.
If the victim is conscious or family members are present, quickly gather pertinent medical information for the arriving responders. This information is often summarized using the acronym SAMPLE: Signs and symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading up to the incident. Having this information ready saves time for the EMS team, allowing them to make informed decisions about treatment and transport.
When the EMS team arrives, facilitate a seamless handoff of care. Ensure the path is clear for the emergency personnel and brief them immediately on the victim’s current condition and the care you provided. Providing a concise, accurate report of the initial scene assessment, interventions performed, and medical history ensures continuity of care for the patient.