Timing and composure are everything when it comes to emergency first aid. Would you know how to respond if someone was taken critically ill? Experts explain the basic skills we can all learn and how to perform them with confidence.
Cardiac Arrest
"If you learn one thing, it should be how to resuscitate," says Richard Webber, an associate clinical director of St John Ambulance and practising NHS paramedic in the south of England. "We know that for every one minute delay in restarting the heart, there is a 10% reduction in survivability."
In the UK, about 40,000 out-of-hospital cardiac arrests occur each year, with a current survival rate of 9%, says Emily Le-Gallienne, a resuscitation officer and paramedic for the East of England ambulance service. Countries like Denmark and Sweden have better survival rates because more people are taught CPR skills. A CPR element has just been introduced to the UK driving theory test, which Le-Gallienne calls positive progress. "CPR and defibrillation can increase the chance of survival by up to 70% if done in the first three to five minutes of cardiac arrest, and an ambulance may not arrive in that time."
Before starting CPR, call for an ambulance. Ensure the person is not breathing, as they could be unconscious but not in cardiac arrest, says Oliver Siddell, a paramedic from Leeds. To check, "open their airway by tilting the head back and lifting the chin," says Le-Gallienne. "Look at the chest to see if it is rising and falling, and get close to feel for breath on your cheek. Check for a pulse if confident. If they aren't breathing or breathing is abnormal (slower, irregular, or gasping), it could be cardiac arrest."
Perform chest compressions using the heel of the hand, hands on top of each other, pushing into the centre of the chest. For adults, compress 5-6 cm deep; for children, at least one-third of chest depth (not exceeding 6 cm). Keep a pace of 100-120 beats per minute, using songs like Stayin' Alive by the Bee Gees or Pink Pony Club by Chappell Roan. Ideally, do 30 compressions then two rescue breaths. If uncomfortable with breaths, focus on compressions to buy time. For rescue breaths, pinch the nose, open the mouth, and breathe slowly until the chest rises, then repeat.
Locate your nearest community defibrillator online (e.g., at libraries or former phone boxes). Never leave the injured person alone; send someone else to fetch it. The ambulance service can provide the code for locked cabinets. Automated external defibrillators give clear instructions: they analyse the heart and advise to shock if needed.
A cardiac arrest is when the heart stops pumping blood; a heart attack is a sudden loss of blood flow to heart muscle.
Heart Attack
"A heart attack is central chest pain that comes on suddenly," says Webber. "Pain can go up to the jaw and down the arms, usually the left arm." The heart may not stop, and CPR may not be needed, but many heart attack patients go into cardiac arrest within the first hour. Call for an ambulance and give 300 mg aspirin to chew to help stop the clot. Place the person in a restful sitting position.
Choking
Signs of choking include sudden inability to speak, excessive coughing, flushing, or pointing at the neck. If someone leaves a table coughing, check on them. Encourage coughing first. If ineffective, give up to five back blows with the heel of your hand between the shoulder blades. If still choking, perform abdominal thrusts (Heimlich manoeuvre): stand behind, make a fist with thumb out, place between rib cage and belly button, and push in and up (J-shaped). Repeat as needed.
Drowning
Once out of water, turn the head to let water out of the airway. If not breathing or breathing abnormally, give five rescue breaths and begin CPR. Rescue breaths are crucial because the cardiac arrest is caused by lack of oxygen. Ensure skin is dry before using a defibrillator.
Severe Bleeding
For limb wounds, apply a tourniquet 2-3 cm above the wound, tighten, and elevate. For torso wounds, apply a tight dressing with pressure. If no bandage, use a clean cloth or towel. For severed fingers or limbs, control bleeding first. If possible, collect the part, wrap in clingfilm or plastic, and place somewhere cool (not freezer) or on a bag of frozen peas, avoiding direct ice contact. Do not move suspected broken bones.
Head Injury
Apply an ice pack wrapped in a tea towel to reduce swelling. Seek help if drowsy, disoriented, or continually vomiting. Heads bleed heavily; apply a dressing to control bleeding. For severe injury with unconsciousness, place the person on their side with head tilted back (recovery position) and get help.
To perform the recovery position: kneel beside the person, place the arm closest to you at a right angle, bring the other hand across the chest to rest against the cheek. Bend the knee of the farthest leg, then gently roll them onto their side by pulling on that knee while keeping the hand pressed to the cheek. Tilt the head back to keep the airway open, adjust the top leg so hip and knee are at right angles, and ensure the mouth is angled downward. Monitor breathing until help arrives.
Stroke
Use the FAST mnemonic: Face drooping on one side, Arm weakness on one side, Speech slurred, Time to call emergency services. Early recognition and calling for help are the only first aid needed.
Burns
Place the burnt area under cold running water for at least 10 minutes (ideally 20). Do not use ice. Cover with clingfilm or a wet dressing to prevent sticking. Do not pop blisters, as they protect against infection.
Seizures
Do not put anything in the person's mouth. Place something soft under their head if needed. Let the seizure finish, ensure the airway is clear, then place them on their side or in the recovery position. Call for help if the person is not known to have seizures, has more than one seizure, or if a seizure lasts more than five minutes. For fainting, elevate the legs to help blood return to the brain.
Anaphylactic Shock
Anaphylaxis is a life-threatening allergic reaction. Signs include noisy breathing, swollen tongue, wheezing, clamminess, or loss of consciousness. Call 999 immediately and lay the person down. Raise their legs if possible. If the person has an adrenaline auto-injector, administer it as soon as possible.
