Which it the correct first step when you arrive at a scene where a person has collapsed?

If someone is injured in an incident, first check that you and the person who is injured are not in any danger. If you are, make the situation safe.

When it's safe to do so, assess the person who is injured and, if necessary, dial 999 for an ambulance. You can then carry out basic first aid.

Assessing an injured person

The 3 priorities when dealing with a casualty are commonly referred to as ABC, which stands for:

• Airway
• Breathing
• Circulation

Airway

If the person appears unresponsive, ask them loudly if they're OK and if they can open their eyes.

If they respond, you can leave them in the position they're in until help arrives.

While you wait, keep checking their breathing, pulse and level of response:

• Are they alert?
• Do they respond to your voice?
• Is there no response to any stimulus (are they unconscious)?

If there's no response, leave the person in the position they're in and open their airway.

If this is not possible in the position they're in, gently lay them on their back and then try to open their airway.

To open the airway, place 1 hand on the person's forehead and gently tilt their head back, lifting the tip of the chin using 2 fingers. This moves the tongue away from the back of the throat.

Don't push on the floor of the mouth, as this will push the tongue upwards and obstruct the airway.

If you think the person may have a spinal injury, place your hands on either side of their head and use your fingertips to gently lift the angle of the jaw forward and upwards, without moving the head, to open the airway.

Take care not to move the person's neck. But opening the airway takes priority over a neck injury. This is known as the jaw thrust technique.

Breathing

To check if a person is still breathing:

• look to see if their chest is rising and falling
• listen over their mouth and nose for breathing sounds
• feel their breath against your cheek for 10 seconds

If they're breathing normally, place them in the recovery position so their airway remains clear of obstructions, and continue to monitor normal breathing.

Gasping or irregular breathing is not normal breathing.

If the person isn't breathing or is not breathing normally, call 999 for an ambulance and then begin CPR.

Circulation

If the person isn't breathing normally, you must start chest compressions immediately.

Agonal breathing is common in the first few minutes after a sudden cardiac arrest (when the heart stops beating).

Agonal breathing is sudden, irregular gasps of breath. This shouldn't be mistaken for normal breathing and CPR should be given straight away.

If the person isn't breathing, call 999 for an ambulance and then begin CPR.

First aid courses

The advice given on this page only covers common first aid situations and is not a replacement for taking a first aid training course.

Basic first aid courses are run regularly in most areas around the UK.

Organisations that offer courses include:

• St John Ambulance
• British Red Cross
• NHS Ambulance Service
• St Andrew's First Aid

If a person is unconscious but is breathing and has no other life-threatening conditions, they should be placed in the recovery position.

Putting someone in the recovery position will keep their airway clear and open. It also ensures that any vomit or fluid won't cause them to choke.

Or follow these steps:

• With the person lying on their back, kneel on the floor at their side.
• Extend the arm nearest you at a right angle to their body with their palm facing up.
• Take their other arm and fold it so the back of their hand rests on the cheek closest to you, and hold it in place.
• Use your free hand to bend the person's knee farthest away from you to a right angle.
• Carefully roll the person onto their side by pulling on the bent knee towards you.
• Their bent arm should be supporting the head, and their extended arm will stop you rolling them too far.
• Make sure their bent leg is at a right angle.
• Open their airway by gently tilting their head back and lifting their chin, and check that nothing is blocking their airway.
• Stay with the person and monitor their condition until help arrives.

Spinal injury

If you think a person may have a spinal injury, do not attempt to move them until the emergency services reach you.

If it's necessary to open their airway, place your hands on either side of their head and gently lift their jaw with your fingertips to open the airway. Take care not to move their neck.

You should suspect a spinal injury if the person:

• has been involved in an incident that's directly affected their spine, such as a fall from height or being struck directly in the back
• complains of severe pain in their neck or back
• is not able to move their neck
• feels weak, numb or unable to move (paralysed)
• has lost control of their limbs, bladder or bowels