In any medical emergency, the first three steps are always the same: make sure the scene is safe, call 911 (or your local emergency number), and provide basic care until help arrives. Those few minutes between the onset of an emergency and the arrival of paramedics are when bystander actions matter most. Knowing what to do, and in what order, can genuinely save a life.
The Universal Steps for Any Emergency
Before you touch anyone or rush in to help, look around. Is the scene safe for you? Downed power lines, traffic, fire, chemical spills, or an active threat can turn one victim into two. If you can quickly eliminate the hazard, do it. If you can’t, stay back and call for specialized help immediately.
Once you’re safely beside the person, assess three things in this order: Are they conscious? Are they breathing? Do they have signs of circulation, like a pulse or normal skin color? This quick check tells you whether you’re dealing with something that threatens their life right now or something that can wait for paramedics. If the person is unconscious and not breathing normally, you’re looking at a cardiac arrest situation and need to start CPR (covered below). If they’re conscious and talking, your job shifts to keeping them calm, still, and comfortable while you gather information for the 911 dispatcher.
What to Tell the 911 Dispatcher
When you call 911, the dispatcher will guide you, but having the key details ready speeds everything up. Be prepared to provide:
- The exact address of the emergency. If you don’t know it, give the nearest cross street or landmark and a direction.
- Your phone number and name.
- What is happening right now. Be concise. Describe the current problem, not the full backstory.
- The patient’s approximate age.
- Whether the patient is conscious and breathing.
Stay on the line. Dispatchers are trained to walk you through first aid steps while the ambulance is en route. They can tell you whether to reposition the person, start chest compressions, or administer something like aspirin for a suspected heart attack.
Why You Should Almost Always Call an Ambulance
It’s tempting to throw someone in the car and drive to the hospital yourself, but for serious emergencies, an ambulance is almost always the better choice. Ambulances carry defibrillators, ventilators, oxygen, airway suction equipment, and cardiac monitors. Paramedics can begin life-saving treatment the moment they arrive, not 15 minutes later in an ER parking lot. For cardiac events, strokes, severe allergic reactions, major trauma, or any situation where the person could stop breathing or lose consciousness, call 911 rather than driving.
Driving yourself or someone else makes sense only for minor emergencies where the person is stable, alert, and unlikely to deteriorate, like a broken finger or a cut that needs stitches.
How to Perform CPR
If someone collapses and isn’t breathing normally (or is only gasping), call 911 and start chest compressions immediately. Place the heel of one hand on the center of their chest, put your other hand on top, and push hard and fast. The American Heart Association recommends compressing at least 2 inches deep at a rate of 100 to 120 compressions per minute. That’s roughly the tempo of the song “Stayin’ Alive.”
Let the chest fully recoil between each compression. If you’re trained in rescue breathing, give two breaths after every 30 compressions. If you’re not trained or not comfortable with mouth-to-mouth, hands-only CPR (just compressions, no breaths) is still highly effective and far better than doing nothing. Keep going until paramedics arrive or the person starts breathing on their own. If an automated external defibrillator (AED) is nearby, send someone to grab it. AEDs give voice-guided instructions and are designed for untrained bystanders to use.
Responding to a Heart Attack
Heart attack symptoms aren’t always dramatic. The person may feel crushing chest pain, but they might also have more subtle signs: pressure or tightness in the chest, pain radiating to the jaw, neck, or left arm, shortness of breath, nausea, or sudden cold sweats. Women are especially likely to experience the less obvious symptoms.
Have the person sit down, rest, and stay as calm as possible. Call 911 immediately. Many experts, including those at UF Health, recommend having the person chew and swallow a full-dose aspirin (325 mg) while waiting for the ambulance, as long as they’re not allergic to aspirin and don’t have a condition that makes it dangerous. Chewing gets the aspirin into the bloodstream faster than swallowing it whole. The 911 dispatcher can help you decide whether aspirin is appropriate.
Recognizing a Stroke
With stroke, every minute costs brain cells. The American Stroke Association uses the acronym FAST to help bystanders spot the signs:
- Face: Ask the person to smile. Is one side of their face drooping or twisting?
- Arms: Ask them to raise both arms. Does one arm drift downward?
- Speech: Ask them to repeat a simple sentence. Is their speech slurred or strange?
- Time: If you see any of these signs, call 911 immediately.
Do not drive the person to the hospital yourself. Stroke treatments are time-sensitive, and paramedics can alert the hospital to prepare a specialized team before arrival. Note the exact time symptoms started, because the treatment window depends on it.
Helping Someone Who Is Choking
If an adult or child older than one year is choking and can’t cough, speak, or breathe, stand or kneel behind them and wrap your arms around their waist. Make a fist and place the thumb side against their belly, just above the belly button but well below the breastbone. Grasp your fist with your other hand and deliver quick upward thrusts into the abdomen. Repeat until the object comes out or the person loses consciousness. If they’re standing, place one of your legs between theirs so you can support them if they faint.
For a baby younger than one year, the technique is completely different. Lay the baby face down on your forearm with their head lower than their chest, supporting their head in your palm against your thigh. Use the heel of your hand to deliver up to five firm back slaps between the shoulder blades. If that doesn’t work, flip the baby face up on your thigh (keeping the head lower than the body) and place two or three fingers just below the nipple line on the breastbone. Give five quick chest thrusts, using the same position you’d use for infant CPR. Alternate between back blows and chest thrusts until the object comes out.
Keep Emergency Health Info Ready
When paramedics arrive, they need answers fast, especially if the patient can’t speak. The Mayo Clinic recommends keeping a health record (paper or digital) that includes your name, age, address, current medications with doses and schedules, chronic conditions like epilepsy or diabetes, known allergies, immunization history, any medical equipment you use, and emergency contact numbers for both your doctor and a family member or friend.
One practical approach: write this information on an index card and post it on your refrigerator door. Emergency responders are trained to check the fridge for exactly this kind of information. If you take medications, keeping an updated list in your wallet or phone accomplishes the same thing. For family members with serious conditions, a signed medical consent form stored with this information can help paramedics make faster decisions if the patient is unconscious.