First aid

Overview

First aid
First aid

Every year in the UK, thousands of people die or are seriously injured in incidents.  Many deaths could be prevented if first aid was given before emergency services arrive.

What to do

If someone is injured you should:

  • first check that you and the casualty aren't in any danger, and, if possible, make the situation safe
  • if necessary, dial 999 for an ambulance when it's safe to do so
  • carry out basic first aid

If someone is unconscious and breathing

If someone is unconscious but breathing, and has no other injuries that would stop them being moved, place them in the recovery position until help arrives.

Keep them under observation to ensure they continue to breathe normally.

If someone is unconscious and not breathing

If someone is not breathing normally, call 999 and start cardiopulmonary resuscitation (CPR) straight away.

Find out more about CPR 

Common accidents and emergencies

Here are some of the most common injuries that may need emergency treatment in the UK and information about how to deal with them:

Anaphylaxis

Anaphylaxis (or anaphylactic shock) is a severe allergic reaction that can occur after an insect sting or eating certain foods.

The adverse reaction can be very fast, occurring within seconds or minutes of coming into contact with the substance the person is allergic to (allergen).

During anaphylactic shock, it may be difficult for the person to breathe, as their tongue and throat may swell, obstructing their airway.

Call 999 immediately if you think someone is experiencing anaphylactic shock.

Check if the person is carrying any medication. Some people who know they have severe allergies may carry an adrenaline self-injector, which is a type of pre-loaded syringe.

You can either help the person administer their medication or, if you're trained to do so, give it to them yourself.

After the injection, continue to look after the person until medical help arrives. 

All casualties who have had an intramuscular or subcutaneous (under the skin) injection of adrenaline must be seen and medically checked by a healthcare professional as soon as possible after the injection has been given.

Make sure they're comfortable and can breathe as best they can while waiting for medical help to arrive.

If they're conscious, sitting upright is normally the best position for them.

Find out how to treat anaphylaxis.

Bleeding heavily

If someone is bleeding heavily, the main aim is to prevent further blood loss and minimise the effects of shock.

First, dial 999 and ask for an ambulance as soon as possible.

If you have disposable gloves, use them to reduce the risk of any infection being passed on.

Check that there's nothing embedded in the wound. If there is, take care not to press down on the object.

Instead, press firmly on either side of the object and build up padding around it before bandaging, to avoid putting pressure on the object itself.

Do not try to remove it because it may be helping to slow down the bleeding.

If nothing is embedded:

  • apply and maintain pressure to the wound with your gloved hand, using a clean pad or dressing if possible; continue to apply pressure until the bleeding stops
  • use a clean dressing to bandage the wound firmly
  • if bleeding continues through the pad, apply pressure to the wound  until the bleeding stops and then apply another pad over the top and bandage it in place; don't remove the original pad or dressing, but continue to check that the bleeding has stopped

If a body part, such as a finger, has been severed, place it in a plastic bag or wrap it in cling film. Do not wash the severed limb.

Wrap the package in soft fabric and place in a container of crushed ice. Do not let the limb touch the ice.

Make sure the severed limb goes with the patient to hospital.

Always seek medical help for bleeding unless it's minor.

Find out how to treat cuts and grazes and how to treat nosebleeds.

Burns and scalds

If someone has a burn or scald:

  • cool the burn as quickly as possible with cool running water for at least 20 minutes, or until the pain is relieved
  • call 999 or seek medical help, if needed
  • while cooling the burn, carefully remove any clothing or jewellery, unless it's attached to the skin
  • if you're cooling a large burnt area, particularly in babies, children and elderly people, be aware that it may cause hypothermia (it may be necessary to stop cooling the burn to avoid hypothermia)
  • if the burn has cooled, cover it loosely with cling film. If cling film isn't available, use a clean, dry dressing or non-fluffy material. Do not wrap the burn tightly as swelling may lead to further injury
  • do not apply creams, lotions or sprays to the burn

If you are not sure if medical help is needed or what to do next, call 111.

Find out how to treat burns and scalds

Chemical burns

For chemical burns, wear protective gloves, remove any affected clothing, and rinse the burn with cool running water for at least 20 minutes to remove the chemical.

If possible, determine the cause of the injury.

In certain situations where a chemical is regularly handled, a specific chemical antidote may be available to use.

Be careful not to contaminate and injure yourself with the chemical, and wear protective clothing if necessary.

Call 999 for immediate medical help.

Choking

The following information is for choking in adults. There is separate advice on how to stop a child from choking.

Mild choking

If the airway is only partly blocked, the person will usually be able to speak, cry, cough or breathe.

In situations like this, a person will usually be able to clear the blockage themselves.

If choking is mild:

  • encourage the person to cough to try to clear the blockage
  • ask them to try to spit out the object if it’s in their mouth
  • do not put your fingers in their mouth if you can't see the object, as you risk pushing it further down their mouth

If coughing doesn’t work, start back blows.

Severe choking

If choking is severe, the person won’t be able to speak, cry, cough or breathe, and without help they’ll eventually become unconscious. If coughing doesn't work start back blows.

How to do back blows

To help an adult or child over 1 year old:

  • Stand behind the person and slightly to one side. Support their chest with 1 hand. Lean the person forward so the object blocking their airway will come out of their mouth, rather than moving further down.
  • Give up to 5 sharp blows between the person’s shoulder blades with the heel of your hand (the heel is between the palm of your hand and your wrist).
  • Check if the blockage has cleared.
  • If not, give up to 5 abdominal thrusts

Do not give abdominal thrusts to babies under 1 year old or to pregnant women.

To perform abdominal thrusts on a person who is severely choking and isn’t in one of the above groups:

  • stand behind the person who is choking.
  • place your arms around their waist and bend them well forward.
  • clench 1 fist and place it just above the person's belly button.
  • place your other hand on top of your fist and pull sharply inwards and upwards.
  • repeat this up to 5 times.

The aim is to get the obstruction out with each chest thrust, rather than necessarily doing all 5.

If the person's airway is still blocked after trying back blows and abdominal thrusts:

  • Call 999 and ask for an ambulance. Tell the 999 operator that the person is choking.
  • Continue with the cycles of 5 back blows and 5 abdominal thrusts until help arrives.

The person choking should always be seen by a healthcare professional afterwards to check for any injuries or small pieces of the obstruction that remain.

Drowning

If someone is in difficulty in water, don't enter the water to help unless it's safe to do so. Don't put yourself at risk.

Once the person is on land, you need to check if they're breathing. Ask someone to call 999 for medical help.

If they're not breathing, open the airway and give 5 initial rescue breaths before starting CPR.

Find out how to give CPR, including rescue breaths.

If the person is unconscious but still breathing, put them into the recovery position with their head lower than their body and call an ambulance immediately.

Continue to observe the casualty to ensure they don't stop breathing and continue to breathe normally.

Electric shock (domestic)

If someone has had an electric shock, switch off the electrical current at the mains to break the contact between the person and the electrical supply.

If you can't reach the mains supply:

  • do not go near or touch the person until you're sure the electrical supply has been switched off
  • once the power supply has been switched off, and if the person isn't breathing, dial 999 for an ambulance

Afterwards, seek medical help.

Fractures

It can be difficult to tell if a person has a broken bone or a joint, as opposed to a simple muscular injury. If you're in any doubt, treat the injury as a broken bone.

If the person is unconscious or is bleeding heavily, these must be dealt with first, by controlling the bleeding with direct pressure and performing performing CPR. See the section on bleeding on this page.

If the person is conscious, prevent any further pain or damage by keeping the fracture as still as possible until you get them safely to hospital.

Once you havew done this, decide whether the best way to get them to hospital is by ambulance or car.

If the pain isn’t too severe, you could transport them to hospital by car. Get someone else to drive if possible so you can care for the casualty during the trip.

But call 999 if:

  • they’re in a lot of pain and in need of strong painkilling medication - call an ambulance and do not move them
  • it's obvious they have a broken leg - do not move them, but keep them in the position you found them in and call an ambulance
  • you suspect they have injured or broken their back - call an ambulance and do not move them

Do not give the casualty anything to eat or drink, because they may need an anaesthetic (numbing medication) when they reach hospital.

You can read more about specific broken bones in the following pages:

Heart attack

heart attack is one of the most common life-threatening heart conditions in the UK.

If you think someone is having or has had a heart attack, call 999 and then move them into a comfortable sitting position.

Symptoms of a heart attack include:

  • chest pain – the pain is usually located in the centre or left side of the chest and can feel like a sensation of pressure, tightness or squeezing
  • pain in other parts of the body – it can feel as if the pain is travelling from the chest down one or both arms, or into the jaw, neck, back or abdomen (tummy)

Sit the person down and make them comfortable.

If they can, it's best for them to sit on the floor with their knees bent and their head and shoulders supported. If possible, place cushions behind them or under their knees.

If they're conscious, reassure them and ask them to take a 300mg aspirin tablet to chew slowly (unless you know they shouldn't take aspirin – for example, if they're under 16 or allergic to it).

If the person has any medication for angina, help them to take it.

Monitor their vital signs, such as breathing, until help arrives.

If the person deteriorates and becomes unconscious, open their airway, check their breathing and, if necessary, start CPR.

Call 999 to tell them you think the person is now in cardiac arrest (their heart has stopped beating).

Poisoning

Poisoning is potentially life-threatening.

Common causes of poisoning include:

  • swallowing a toxic substance, such as bleach
  • taking an overdose of a prescription medicine
  • eaten something, like wild plants and fungi. 

Alcohol poisoning can cause similar symptoms.

If you think someone has swallowed a poisonous substance, call 999 to get immediate medical help and advice.

The effects of poisoning depend on the substance swallowed, but can include vomiting, loss of consciousness, pain or a burning sensation.

The following advice is important:

  • find out what's been swallowed so you can tell the paramedic or doctor
  • do not give the person anything to eat or drink unless a healthcare professional advises you to
  • do not try to cause vomiting
  • stay with the person, as their condition may get worse and they could become unconscious.

If the person becomes unconscious while you're waiting for help to arrive, check for breathing and, if necessary, perform CPR.

Do not perform mouth-to-mouth resuscitation if the person's mouth or airway is contaminated with the poison.

Do not leave them if they're unconscious: they could vomit. The vomit could then enter their lungs and make them choke.

If they do vomit naturally, try to collect some of it for the ambulance crew - this may help identify the cause of the poisoning.

If the patient is conscious and breathing normally, put them into the recovery position and keep checking they're breathing normally.

Read more about treament for poisoning and alcohol poisoning.

Shock

In the case of a serious injury or illness, it's important to look out for signs of shock.

Shock is a life-threatening condition that occurs when the circulatory system fails to provide enough oxygenated blood to the body and, as a result, deprives the vital organs of oxygen.

This is usually the result of severe blood loss, but it can also occur after severe burns, severe vomiting, a heart attack, bacterial infection or a severe allergic reaction (anaphylaxis).

The type of shock described here isn't the same as the emotional response of feeling shocked, which can also occur after an accident.

Signs of shock include:

  • pale, cold, clammy skin
  • sweating
  • rapid, shallow breathing
  • weakness and dizziness
  • feeling sick and possibly vomiting
  • thirst
  • yawning
  • sighing

Seek medical help immediately if you notice that someone has any of the above signs of shock.

If they do, you should:

  • call 999 as soon as possible and ask for an ambulance
  • treat any obvious injuries
  • lie the person down if their injuries allow you to and, if possible, raise and support their legs
  • use a coat or blanket to keep them warm
  • do not give them anything to eat or drink
  • give them lots of comfort and reassurance
  • monitor the person – if they stop breathing, start CPR and call 999 to update them

Stroke

The FAST guide is the most important thing to remember when dealing with people who have had a stroke.

The earlier they receive treatment, the better. Call for emergency medical help straight away.

If you think a person has had a stroke, use the FAST guide:

  • Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.
  • Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
  • Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.
  • Time – it's time to dial 999 immediately if you notice any of these signs or symptoms.

If a person had symptoms of a stroke but they do not have them now, you should still call 999 as it may have been a mini-stroke (also called a transient ischaemic attack or TIA).

Find out more about the symptoms of a stroke.

Calling 999 to get help in an emergency

When you call 999, you'll be asked what service you need, as well as:
  • your telephone number
  • the address you're calling from
  • a brief description of what's wrong with the casualty and whether they're bleeding, unconscious or not breathing

The call handler may advise you on how what you can do until help arrives.

After an accident

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 casualty 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 open their airway.

To open the airway, place 1 hand on the casualty’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 casualty isn't breathing or is not breathing normally, call 999 for an ambulance and then begin CPR.

Circulation

If the casualty 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:

CPR

This page provides information and guidance about cardiopulmonary resuscitation (CPR). This includes hands-only CPR and CPR with rescue breaths.

If someone is unconscious and not breathing normally, call 999 and start CPR straight away.

When you call for an ambulance, telephone systems now exist that can give basic life-saving instructions, including advice about CPR.

CPR on adults

If you have been trained in CPR, including rescue breaths, and feel confident using your skills, you should give chest compressions with rescue breaths.

If you're not completely confident, attempt hands-only CPR instead.

Hands-only CPR:

To carry out a chest compression:

  1. Place the heel of your hand on the breastbone at the centre of the person’s chest. Place your other hand on top of your first hand and interlock your fingers.
  2. Position yourself with your shoulders above your hands.
  3. Using your body weight (not just your arms), press straight down by 5-6cm (2-2.5 inches) on their chest.
  4. Keeping your hands on their chest, release the compression and allow the chest to return to its original position. 
  5. Repeat these compressions at a rate of 100 to 120 times per minute until an ambulance arrives or you become exhausted.

CPR with rescue breaths

Place the heel of your hand on the centre of the person's chest, then place the other hand on top and press down by 5-6cm (2-2.5 inches) at a steady rate of 100 to 120 compressions per minute.

  1. Place the heel of your hand on the centre of the person's chest, then place the other hand on top and press down by 5 to 6cm (2 to 2.5 inches) at a steady rate of 100 to 120 compressions a minute.After every 30 chest compressions, give 2 rescue breaths.
  2. After every 30 chest compressions, give 2 rescue breaths.
  3. Tilt the casualty's head gently and lift the chin up with 2 fingers. Pinch the person's nose. Seal your mouth over their mouth, and blow steadily and firmly into their mouth for about 1 second. Check that their chest rises. Give 2 rescue breaths.
  4. Continue with cycles of 30 chest compressions and 2 rescue breaths until they begin to recover or emergency help arrives.

Coronavirus (COVID-19) advice

If there's a chance the person who's unwell has COVID-19, place a cloth or towel over their mouth and nose and do hands-only CPR until an ambulance arrives.

For more information, see:

CPR on children

You should carry out CPR with rescue breaths on a child. It's more likely children will have a problem with their airways and breathing than a problem with their heart.

Children over 1 year

  1. Open the child's airway by placing 1 hand on their forehead and gently tilting their head back and lifting the chin. Remove any visible obstructions from the mouth and nose.
  2. Pinch their nose. Seal your mouth over their mouth, and blow steadily and firmly into their mouth, checking that their chest rises. Give 5 initial rescue breaths.
  3. Place the heel of 1 hand on the centre of their chest and push down by 5cm (about 2 inches), which is approximately one-third of the chest diameter. The quality (depth) of chest compressions is very important. Use 2 hands if you can't achieve a depth of 5cm using 1 hand.
  4. After every 30 chest compressions at a rate of 100 to 120 a minute, give 2 breaths.
  5. Continue with cycles of 30 chest compressions and 2 rescue breaths until they begin to recover or emergency help arrives.

Infants under 1 year

  1. Open the infant's airway by placing 1 hand on their forehead and gently tilting the head back and lifting the chin. Remove any visible obstructions from the mouth and nose.
  2. Place your mouth over the mouth and nose of the infant and blow steadily and firmly into their mouth, checking that their chest rises. Give 5 initial rescue breaths.
  3. Place 2 fingers in the middle of the chest and push down by 4cm (about 1.5 inches), which is approximately one-third of the chest diameter. The quality (depth) of chest compressions is very important. Use the heel of 1 hand if you can't achieve a depth of 4cm using the tips of 2 fingers.
  4. After 30 chest compressions at a rate of 100 to 120 a minute, give 2 rescue breaths.
  5. Continue with cycles of 30 chest compressions and 2 rescue breaths until they begin to recover or emergency help arrives.

Recovery position

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.

To place some one in the recovery position 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 from you to a right angle.
  • carefully roll the person onto their side by pulling on the bent knee.
  • 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


The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 08/09/2023 11:44:38