Encountering an unresponsive individual requires decisive action, as the first few minutes can significantly change the outcome. Approaching this medical emergency with a calm, methodical plan is paramount for the safety of both the patient and the rescuer. This protocol provides a step-by-step guide to manage the situation and deliver immediate aid until trained professionals arrive. The sequence of actions is designed to address the most immediate life threats first, maximizing the chance of patient recovery.
Ensuring Scene Safety and Assessing Responsiveness
Before approaching the patient, the rescuer must prioritize their own safety by quickly scanning the environment for hazards, such as electrical wires, traffic, or spilled chemicals. Only after confirming the scene is secure should you move toward the patient to begin the assessment. This initial step, often referred to as “Danger,” is a prerequisite to any first aid intervention.
Once the scene is safe, determine if the patient is truly unresponsive using the “Tap and Shout” method. Gently tap the patient’s shoulders and ask loudly, “Are you okay?” If there is no reaction—no movement, sound, or opening of the eyes—the person is considered unresponsive.
If the patient is found lying face down, reposition them onto their back to assess breathing and open the airway. Use a careful “log roll” technique, moving the head, shoulders, and torso as a single unit to minimize potential spinal movement. Identifying unresponsiveness immediately signals the need to activate the emergency response system.
Activating Emergency Medical Services
Calling for professional help is the immediate next step after confirming unresponsiveness. If you are alone, call the local emergency number, such as 911, immediately before beginning further interventions. If a bystander is present, direct them clearly to make the call and, if possible, to find an automated external defibrillator (AED).
The dispatcher requires specific information to ensure the fastest response time. Clearly state your exact location, including the street address, nearest cross street, and any identifying landmarks. Report that you have an unresponsive person who is not breathing normally, or at all, and specify the patient’s approximate age and gender if known.
Remain calm and answer all the dispatcher’s questions accurately, as they are trained to provide telephone guidance for life-saving procedures. Do not end the call until the dispatcher instructs you to hang up, as they may provide instructions for care or alert you to the ambulance’s arrival.
Performing the Primary Survey and Immediate Interventions
The primary survey follows a systematic approach remembered as Airway, Breathing, and Circulation (ABC), with immediate intervention required if a problem is found. The first step, Airway, involves ensuring the patient’s breathing passage is clear by performing a head-tilt/chin-lift maneuver, unless a spinal injury is suspected. This action moves the tongue away from the back of the throat, preventing it from obstructing the airway.
Following the Airway check, assess for Breathing by looking for the rise and fall of the chest and listening for normal breath sounds for no more than 10 seconds. If the patient is not breathing or is only gasping irregularly, immediate cardiopulmonary resuscitation (CPR) must be initiated. For adults, high-quality chest compressions should be delivered at a rate of 100 to 120 compressions per minute, with a depth of at least two inches.
If the patient is unresponsive but is breathing normally, they should be placed into the recovery position to protect their airway. This side-lying posture allows any fluids, such as vomit or blood, to drain from the mouth, preventing aspiration into the lungs. The patient’s upper knee should be bent to stabilize the body, and the head should be supported by the upper arm to maintain a slight backward tilt, keeping the airway open.
The Circulation check involves scanning the patient for severe external bleeding that requires immediate control. If bleeding is present, direct, firm pressure must be applied to the wound immediately, even while continuing other interventions like CPR if necessary. Controlling massive hemorrhage is a simultaneous priority alongside managing the patient’s airway and breathing.
Ongoing Monitoring and Handover to Professionals
After initiating life-saving interventions, continuous monitoring of the patient’s status is necessary while awaiting the arrival of emergency medical services (EMS). The rescuer must regularly check the patient’s breathing and level of responsiveness, being prepared to switch from the recovery position back to CPR if normal breathing stops. Any change in the patient’s condition should be noted.
If bystanders are present, delegate simple tasks to prepare for the EMS arrival, such as securing any pets, clearing a path to the patient, or waiting outside to guide the ambulance crew to the exact location. This helps to streamline the transition of care and saves valuable time for the arriving team.
When the professionals arrive, the rescuer must provide a concise and factual handover of information. This should include what led to the patient being found, the time the patient was discovered unresponsive, and a summary of all actions taken. Report the patient’s initial status, the interventions performed (e.g., “I started chest compressions at 8:15 AM”), and any changes in their condition since care began. This clear communication ensures the medical team can seamlessly continue treatment.