We are continually hearing how the NHS is struggling to cope at the moment and the UK’s ambulance service is under more pressure than ever. You are therefore extremely likely to be waiting for an ambulance for a lot longer than the target of 8 minutes, even in a life-threatening emergency. Thus first aid skills are of critical importance and key to a casualty’s survival.

To avoid overloading the emergency services, it is vital to be able to assess when someone is seriously ill or hurt and whether it is better to call an ambulance, go to A&E or to your GP.

The following article aims to give you guidance to be able to help in a range of emergency situations, making the most of those initial vital minutes before the ambulance arrives.

Most sections include a video link which goes into more detail on each situation.

Approaching an accident, what should you do?

If you are first on scene and find someone who has collapsed or had an accident, what you do in those first vital minutes is of critical importance and could make the difference between life and death.

  1. Take a deep breath, collect your thoughts and stay calm.
  2. Check for danger. Have a look around, see what might have happened to them and guard your own safety as well as that of the casualty. If you become a casualty too you are no longer able to help.
  3. Check for response. Speak to them, if there is no response, gently shake them to see if they’re conscious.

If there is still no response:

Open the airway and check for breathing.

What to do before the ambulance arrives

If they are breathing, put them in the recovery position.

What to do before the ambulance arrives

If they are not breathing, start CPR.

What you can do to Help While Waiting for an Ambulance

30 chest compressions followed by 2 breaths and repeated. For a baby or child start with 5 breaths.

When should you call the ambulance service?

If there is someone else who can call an ambulance, get them to do so straight away.

If you are on your own and if the person is unconscious and breathing, put them in the recovery position first and then make that emergency call.

If the person is unconscious and not breathing;  If an adult, start CPR straight away, if a baby or child do a minute’s CPR (starting with 5 rescue breaths) and then phone for an ambulance.

If the person is conscious, control any bleeding and perform any other essential life-saving first aid as quickly as possible to stabilise their condition. Help the casualty to administer any medication if appropriate, for example GTN spray, asthma pump, Epipen etc. prior to calling an ambulance.

What should you do while waiting for an ambulance?

If the casualty is conscious:

  • Ensure that you and the casualty are safe from further danger and continually re-evaluate this.
  • Keep yourself and the casualty calm.
  • Check that they have no problems breathing and control any bleeding with direct pressure.
  • Keep them warm and dry.

Difficulty breathing

If the casualty is struggling to breathe, the best position for them to be in is sitting down in an upright position.

Try and establish why they are having difficulty and if they have any medication to help – are they asthmatic? Could they be having an acute allergic reaction? If so help them administer their medication straight away.

If their condition doesn’t improve, phone the ambulance service again and tell them what is happening.

Possible Heart Attack

If they are showing signs of a heart attack sit them down in an upright position, preferably a lazy W. Encourage them to take their GTN spray if they have one. If they do not feel better and have been prescribed a 300mg Aspirin they should chew this. Phone the emergency services and stress that it is urgent. If they become unconscious and stop breathing, start CPR and if possible, get someone to bring the defibrillator quickly. Get someone to update the ambulance service that your casualty has deteriorated and is now an even higher priority.

What to do before the ambulance arrives

Possible Stroke

If someone is showing signs of a stroke, get them to a stroke unit as quickly as possible. If the ambulance is delayed and you feel safe transporting them, take them there yourself. It is of critical importance that they are swiftly assessed as if they have a blood clot and are treated quickly enough (within a few hours) it is possible to reverse the damage. Continue to reassure the casualty and keep them warm and dry.

Possible Spinal Injury

If they are conscious and you are concerned that they may have damaged their spine, get them to stay still and explain how important it is that they avoid twisting their back or neck. If they are unconscious and breathing, even if you are worried about their spine, if you are concerned about their airway, you should very carefully roll them into the recovery position, protecting their neck and back to avoid twisting.