In any emergency and when it is safe to do so, the first aider should:

  • assess the area
  • assess the patient

Assessment of the area

You may be alerted to the possibility of an emergency by various unusual sights and sounds, or by seeing a person who appears to be either sick or injured.

Before assessing the patient, it is vital to check that the area is safe for you, the patient, and bystanders.

Hazards might include:

  • vehicles
  • electricity, both high and low voltage
  • deep water or rough, fast-flowing water
  • poisonous gases, chemicals or fumes
  • fire

The general rule is to remove the danger to make the scene safe. Where this is not possible, the patient may need to be moved to a safe area.

Assessment of a sick or injured person

Assess the nature of any injury or illness and set priorities for the care required.

If the patient appears collapsed, first check their response to a shouted command and to a firm squeeze of the shoulders. If the collapsed patient does not respond, then CPR may be required.

If the patient responds to your voice, then it is possible to obtain important information and plan any emergency treatment required.

Unless the injury or illness appears to be minor, ask a bystander to call 111 for an ambulance and then follow these simple steps:

  1. Ask the patient and any bystanders for the history of the problem, outlining what happened, the time of onset, and whether there is any known underlying health problem, such as asthma, diabetes, epilepsy or a heart condition. Quickly check for a MedicAlert bracelet or necklet, which may record any major health problem.
  2. Ask the patient to describe any symptoms, including pain, soreness or discomfort, and any other unusual sensations such as numbness or tingling in the fingertips.
  3. Check the patient carefully, looking for any signs of injury or illness, basing your observations on the history and any symptoms described. After an injury, look for any of the following:
  • bleeding
  • bruising
  • wounds
  • swelling
  • deformity (when one side is compared with the other)
  • loss of power or function

The observations should be as follows:

1.    Conscious state: If help is going to be delayed, check the conscious state every few minutes and note any changes. Use the ‘AVPU’ code:

A   Alert

  • Is the patient alert and responding to you?

V   Voice

  • Does the patient respond to your voice?

P   Painful

  • Does the patient respond to a painful stimulus?

U   Unresponsive

  • Is the patient unresponsive?

2.    Airway: ensure that it is clear and open and that the patient does not have any secretions that might obstruct breathing.

3.    Breathing: Check for normal breathing – note the rate and rhythm for any changes. Check whether the breathing is deep or shallow, quiet or noisy, and whether there are any abnormal sounds such as wheezing on breathing out. This is especially important with the unconscious patient because any change may be a warning of deterioration.

4.    Skin: Look at the skin and note the colour (whether tinged with blue), and feel whether it is hot (with fever) or cold and clammy (as in shock).


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