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Accidents and first aid

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

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

What to do

If someone is injured in an accident:

  • First check that you and the casualty are not in any danger. If you are, make the situation safe.
  • When it's safe to do so, dial 999 or 112 for an ambulance, if necessary.
  • Carry out basic first aid.

Read more information about what to do after an incident.

If someone is unconscious and breathing

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

If someone is unconscious and not breathing

If a person is not breathing normally after an incident, call for an ambulance and then, if you can, start CPR straight away. Use hands-only CPR if you are not trained to perform rescue breaths.

Read more about CPR, including instructions and a video on hands-only CPR.

First aid courses

The information on these pages gives some guidance on common first aid situations. However, it is not a replacement for doing a first aid training course. Basic first aid courses are run regularly in most areas around the UK. St John Ambulance, British Red Cross and the NHS Ambulance Service all provide a selection of first aid courses.

Common accidents and emergencies

Below, in alphabetical order, are some of the most common injuries needing emergency treatment in the UK and information on how to deal with them:

Anaphylaxis

Anaphylaxis (or anaphylactic shock) is a severe allergic reaction that can occur after an insect sting or after a person eats certain foods, for example. The reaction can be very fast, happening within seconds or minutes of contact with the thing a person is allergic to.

During anaphylactic shock, a person may find it difficult to breathe and their tongue and throat may also swell, obstructing their airway.

If you suspect a person is experiencing anaphylactic shock, call 999 or 112 straight away.

Check if the person is carrying any medication. Some people who know they have severe allergies may carry an adrenaline 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.

Make sure they are comfortable and can breathe as best they can while waiting for medical help to arrive. If they are conscious, sitting upright is normally the best position for them.

Read more about treating anaphylaxis.

Burns and scalds

In the event of a burn or scald:

  • Cool the burn as quickly as possible with cold (but not ice-cold) running water for a minimum of 10 minutes or until the pain is relieved.
  • Call 999 or seek medical help if necessary.
  • While cooling the burn, carefully remove any clothing or jewellery, unless it is attached to the skin.
  • Keep the person warm using a blanket or layers of clothing (avoiding the injured area) to prevent hypothermia. This is a risk if you are cooling a large burnt area, particularly in babies, children and elderly people. 
  • Cover the burn lengthways with strips of cling film or a clean plastic bag if the burn is on a hand or foot. If no plastic film is available, use a sterile dressing or non-fluffy material. Do not wrap the burn as this may lead to swelling and further injury.
  • Do not put creams, lotions or sprays on the burn.
  • If appropriate, raise the limb to reduce the swelling and offer pain relief.

For chemical burns, wear protective gloves, remove any clothing affected, brush the chemical off the skin if it is a powder and rinse the burn with cold running water for a minimum of 20 minutes. If possible, determine what has caused the injury.

Be careful not to injure yourself, and wear protective clothing if necessary. Call 999 or 112 and arrange immediate medical attention.

Read more information about how to treat burns and scalds.

Bleeding

If someone has severe bleeding, the main aim is to prevent further loss of blood and minimise the effects of shock (see below).

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

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

Check that there is 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. If there is nothing embedded:

  • Apply and maintain pressure to the wound with your hand, using a clean pad if possible.
  • Use a clean dressing to bandage the wound firmly.
  • If the wound is on a limb and there are no fractures, raise the limb to decrease the flow of blood.
  • If bleeding continues through the pad then apply another pad over the top and bandage it in place. Do not remove the original pad or bandage.

If a body part has been severed, such as a finger, do not put it in direct contact with ice. Wrap it in a plastic bag or cling film, then wrap it in a soft material and keep it cool. Once it is wrapped, if possible, place the severed body part in crushed ice.

Always seek medical help for the bleeding unless it is minor. If someone has a nosebleed that has not stopped after 20 minutes, go to the nearest hospital's accident and emergency (A&E) department.

Read more information on:

Choking

The information below is for choking in adults and children over one year old. Read information about what to do if a baby under one year old is 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 continue coughing to try to clear the blockage.
  • Carefully remove any obvious obstruction from the mouth using your first two fingers and thumb.
  • Do not put objects or fingers into the person's throat as this could push the obstruction further into the airway or cause vomiting.

If the obstruction is severe and the person is struggling to breathe, give up to five back blows (between the shoulder blades), using the heel of your hand. Carefully check the mouth and, if possible, remove any obstruction after every blow.

If this does not clear the obstruction, perform abdominal thrusts by following the steps below. This technique should not be used on babies under one year old, pregnant women or people who are obese:

  • Stand behind the person who is choking.
  • Place your arms around their waist and bend them well forward.
  • Clench one first and place it just above the person's belly button and below the breastbone.
  • Place your other hand on top, then pull sharply inwards and upwards.
  • Repeat this up to five times until the object stuck in their throat comes out of their mouth.

The aim is to get the obstruction out with each chest thrust rather than necessarily doing all five. If the obstruction does not clear after three cycles of back blows and chest thrusts, dial 999 or 112 for an ambulance and continue until help arrives.

The person choking should always be checked over by a healthcare professional afterwards to check for any injuries caused by abdominal thrusts or any smaller pieces of the obstruction that remain.

Read more information about what to do if someone is choking.

Drowning

Do not enter the water to help unless it is absolutely essential.

Once the person is on land, if they are not breathing, open the airway and give five initial rescue breaths before starting CPR. If you are alone, perform CPR for one minute before calling for emergency help.

Find out how to give CPR, including rescue breaths.

If the person is unconscious but still breathing, turn them into the recovery position with their head lower than their body to allow water to drain out, and call an ambulance immediately.

Electricity

If someone has been electrocuted, dial 999 or 112 for an ambulance.

Switch off the electrical current at the mains to break the contact between the person and the electrical supply.

If you cannot reach the mains supply:

  • Do not go near or touch the person until you are sure any electrical supply has been cut off.
  • Protect yourself by standing on some insulating material (such as a phone book).
  • Using something dry and non-metal, such as a wooden broom handle, push the person away from the electrical source, or move the source away from the person if this is easier.
  • If the person is not breathing, carry out CPR and call an ambulance.

Always seek medical help unless the shock is very minor.

Fractures

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

If the person is unconscious, has difficulty breathing or is bleeding severely, these must be dealt with first.

If the person is conscious, prevent any further pain or damage by keeping the injury still until you get them safely to hospital. Assess the injury and decide the best way to get them to hospital. If they have a broken finger or arm, you may be able to drive them yourself without causing more harm.

  • If they have a broken leg, do not move the person but keep them in the position you found them in. Support the injured part with anything you have handy, for example rolled up blankets or clothes. Call for an ambulance.
  • If you suspect they have injured or broken their spine (back) do not move them and call for an ambulance.
  • Look out for signs of shock. If the person is pale, cold and clammy, has a weak pulse and rapid shallow breathing, they are probably in shock (see below).

If you think that the person may have shock, lie them down and loosen any tight clothing. Do not raise an injured leg. Otherwise, if their injuries allow, raise their legs above the level of their heart by placing something suitable under their feet such as blankets or cushions.

Do not give the person anything to eat or drink as they may need a general anaesthetic when they reach hospital.

Read more information about specific broken bones: 

Heart attack

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

If you think a person is having or has had a heart attack, make them as comfortable as possible and call 999 or 112 for an ambulance. Symptoms of a heart attack include:

  • chest pain – the pain is usually located in the centre 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 to one or both arms, jaw, neck, back or abdomen

Sit the person down.

If they are conscious, reassure them and give them a 300mg aspirin tablet to chew slowly (unless there is any reason not to give them aspirin, for example if they are under 16 or allergic to it). If the person has any medication for angina, such as a spray or tablets, help them to take it. Monitor their vital signs, such as breathing, until help arrives.

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

Poisoning

Poisoning is potentially life threatening. Most cases of poisoning in the UK occur when a person has swallowed a toxic substance such as bleach, an overdose of a prescription drug or eaten wild plants and fungi. Alcohol poisoning can cause similar symptoms.

If you think someone has swallowed a poisonous substance, call 999 or 112 to get immediate medical help.

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

  • Find out what has been swallowed so you can tell the paramedic or doctor.
  • Do not give the person anything to eat or drink unless a health professional advises you to.
  • Never try to cause vomiting. 
  • Stay with the person as their condition may get worse and they could become unconscious.

If the person is unconscious, while you wait for help:

  • Make sure the airway is open and they are breathing. You open the airway by gently tilting the head back and lifting the chin to move the tongue away from the back of the mouth.
  • If they are breathing, turn them into the recovery position, preferably with their head down so any vomit can escape without being swallowed or inhaled.
  • If they are not breathing, perform CPR until they start breathing or medical help arrives.
  • If there are any chemicals on their mouth, use a face shield or pocket mask to protect yourself if you give rescue breaths.

Do not leave the unconscious person as they may roll onto their back. This could cause them to vomit, which could then reach their lungs.

Read more information about treating someone who has been poisoned and treating alcohol poisoning.

Shock

In the case of a serious injury or illness, it is important to watch for signs of shock.

Shock is a life-threatening condition that occurs when the circulatory system fails and, as a result, deprives the vital organs of oxygen. This is usually due to severe blood loss, but it can also happen after severe burns, severe vomiting, a heart attack, bacterial infection or severe allergic reaction (anaphylaxis).

The type of shock described here is not the same thing 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

If you notice any signs of shock in a casualty, seek medical help immediately:

  • Dial 999 or 112 as soon as possible and ask for an ambulance.
  • Treat any obvious injuries.
  • Lay 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, but not smothered.
  • Do not give them anything to eat or drink.
  • Give lots of comfort and reassurance.
  • Monitor the person. If they stop breathing, start CPR.
  • Do not give them anything to drink.

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 suspect a person has had a stroke, use the FAST guide:

  • Facial weakness: is the person unable to smile evenly, or are their eyes or mouth droopy?
  • Arm weakness: is the person only able to raise one arm?
  • Speech problems: is the person unable to speak clearly or understand you?
  • Time to call 999 or 112 for emergency help if a person has any of these symptoms.

Read more information about the symptoms of a stroke.


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Accidents and first aid

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

If someone is injured in an incident, first check that you and the casualty are not in any danger. If you are, make the situation safe. When it's safe to do so, assess the casualty and dial 999 or 112 for an ambulance (if necessary). You can then carry out basic first aid.

Assessing a casualty

The priorities when dealing with a casualty can be remembered as ABC:

  • Airway
  • Breathing
  • Circulation

Airway

If the casualty appears unresponsive, ask them loudly if they are OK and if they can open their eyes. If they respond, you can leave the casualty in the position they are 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?
  • Do they respond to pain?
  • Is there no response to any stimulus (they're unconscious)?

If there is no response, leave the casualty in the position they are in and open their airway. If this is not possible in the position they are in, gently lay them on their back and open the airway.

You open the airway by placing one hand on the casualty’s forehead and gently tilting the head back, then lifting the tip of the chin using two fingers. This is to move the tongue away from the back of the mouth. Do not push on the floor of the mouth as this will cause the tongue to obstruct the airway.

If you think they may have a spinal injury, place your hands on either side of their face and use your fingertips to gently lift the angle of the jaw to open the airway. Take care not to move the casualty’s neck. 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.
  • Feel their breath against your cheek for 10 seconds.

If they are breathing, place them in the recovery position so the airway remains clear of obstructions.

If the casualty is not breathing, call 999 or 112 for an ambulance, then begin CPR.

Circulation

If the heart stops beating, you can help maintain their circulation by performing chest compressions. This is cardiopulmonary resuscitation (CPR) when combined with rescue breaths.

If you are not trained or feel unable to give rescue breaths, you can perform compression-only CPR.

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 should not be mistaken for normal breathing and CPR should be given straight away.


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Accidents and first aid

If a casualty is unconscious but is breathing and has no other life-threatening conditions, they should be placed in the 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 ensure their airway remains clear and open. It also ensures that any vomit or fluid will not cause them to choke.

To place someone in the recovery position:

  • kneel on the floor on one side of the person
  • place the arm nearest you at a right angle to their body with their hand upwards towards the head
  • tuck their other hand under the side of their head, so that the back of their hand is touching their cheek
  • bend the knee farthest from you to a right angle
  • roll the person onto their side carefully by pulling on the bent knee
  • the top arm should be supporting the head and the bottom arm will stop you rolling them too far
  • 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 breathing and pulse continuously until help arrives
  • if their injuries allow you to, turn the person onto their other side after 30 minutes

Spinal injury

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

If it is necessary to open their airway, place your hands on either side of their face 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 a head injury, especially one where there has been a large blow on the back of the head, and is or has been unconscious
  • complains of severe pain in their neck or back
  • won't move their neck
  • feels weak, numb or paralysed
  • has lost control of their limbs, bladder or bowels
  • has a twisted neck or back

If you must move the person (for example, because they are vomiting, choking or they are in danger of further injury), you will need assistance to roll them.


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Accidents and first aid

Cardiopulmonary resuscitation (CPR) is a first aid technique that can be used if someone is not breathing properly or if their heart has stopped.

Cardiopulmonary resuscitation (CPR) is a first aid technique that can be used if someone is not breathing properly or if their heart has stopped.

Chest compressions and rescue breaths keep blood and oxygen circulating in the body.

If someone is not breathing normally and is not moving or responding to you after an accident, call 999 or 112 for an ambulance. Then, if you can, start CPR straight away.

Hands-only CPR

If you have not been trained in CPR or are worried about giving mouth-to-mouth resuscitation to a stranger, you can do chest compression-only (or 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 on their chest.
  4. Repeat this until an ambulance arrives.

Try to perform chest compressions at 100-120 chest compressions a minute.

When you call for an ambulance, telephone systems now exist that can give basic life-saving instructions, including advice on CPR. These are now common and are easily accessible with mobile phones.

CPR with rescue breaths

If you’ve been trained in CPR, including rescue breaths, and feel confident using your skills, you should give chest compressions with rescue breaths. If you are not completely confident, attempt hands-only CPR instead (see above).

Adults

  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 5–6cm at a steady rate, at approximately 100 compressions per minute.
  2. After every 30 chest compressions, give two breaths.
  3. Tilt the casualty's head gently and lift the chin up with two fingers. Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth. Check that their chest rises. Give two rescue breaths.
  4. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

Children over one year old

  1. Open the child's airway by placing one hand on the child’s 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 five initial rescue breaths.
  3. Place the heel of your hand on the centre of their chest and press down by at least one-third of the depth of the chest. Use two hands if you can't press down hard enough with one.
  4. After every 30 chest compressions at a rate of 100 per minute, give two breaths.
  5. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

Babies under one year old

  1. Open the baby's airway by placing one 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 five initial rescue breaths.
  3. Place two fingers in the middle of the chest and press down by one-third of the depth of the chest. Use the heel of one hand if you cannot press deep enough with two fingers.
  4. After 30 chest compressions at a rate of 100 per minute, give two breaths.
  5. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

Read more information about how to resuscitate a child.


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