Hesperian Health Guides

First Aid

Establish Calm and Control

When an emergency happens, having a step-by-step approach to the problems facing you can help you think clearly and care for the most important problems first.

1. Take a deep breath. Emergencies can be scary. But the calmer you are, the more useful you will be. Being calm will also comfort and help the injured person or people around you.
2. Ask yourself: is this place safe? Move the person and yourself away from fires, busy streets, or other dangers.
(If the person might have a neck or back injury, move him carefully so you do not move his neck.)
3. Treat the most dangerous problems first. No matter what caused the injury, check breathing immediately. It is the most important function needed for life. Check if the airway is blocked and if they need rescue breathing.
4. After breathing, check for bleeding. Heavy bleeding can kill.
5. When the person is breathing and heavy bleeding is controlled, check the whole body for other injuries and broken bones. Start at the head and check every part of the body, front and back, down to the toes. Gently ask questions, look the person over, and carefully touch the body to see if there are hidden injuries that may be hard to see at first. It is common to have more than one injury.
6. Try to be as gentle and comforting as you can. Injured people are often scared and in pain. When a person calms down, this helps their fast-beating heart and fast breathing return to normal.

Check breathing often and make sure bleeding is under control. Also check blood pressure, if you can. An injured person may seem fine at first and then suddenly get worse. Regularly re check these important signs until you are sure the person is OK. Keep talking to an injured person. This will help you see if they are confused or if their confusion gets worse.

a woman speaking to a man in a crowd while she helps an injured man.
Please keep the people back. I'll try to help him.


The people who gather after an accident should be encouraged to help. Ask loud, assertive people to clear a space around you and the injured person. Tell someone to go for medical help and someone else to get supplies like cloth (for bandages), or blankets. Giving out tasks will keep people calm and help the urgent tasks get done.

The injured person can also help herself. People can put pressure on their own wounds to stop bleeding. This can focus the person and allows you to check for other injuries or to care for other injured people.

When someone needs help:
? Ask if the person has pain, numbness, or difficulty moving.
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These are signs of sprains, broken ribs or broken bones. If there is numbness or difficulty moving the lower body or the whole body, there may be a spine injury.
Ask or notice if they are having trouble breathing.
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The person may be choking if he cannot cough or talk.
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Stabbing pain with breathing may be a broken rib.
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Shortness of breath and wheezing are signs of asthma. Trouble breathing can also be caused by chemical poisoning or drug overdose.
Notice if they seem confused or have trouble speaking clearly. This can help you to assess how badly injured they are. See what to do if the person is unconscious
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Many people become confused after an accident. But unclear speech, losing consciousness, and lasting confusion can be signs of head injury or intoxication from drug or alcohol use.
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Slurred speech can also be a sign of stroke. Is one side of their face or body drooping or weak? Hospital treatment within a few hours is needed.
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Confusion or changes in consciousness can also be a sign of a diabetic emergency.
? Look carefully: Is there bleeding, swelling, bruises, redness, or disfigured body parts? Compare one side of the body to the other. For example, if one leg looks shorter, it may be broken.
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See what to do for bleeding.
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See information on broken ribs and broken bones.
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Bruising, swelling, and redness can be signs of bleeding inside the body. Watch for shock.
? Feel gently along the head, face, neck, back, front, arms, and legs. Is there pain, numbness, or bones out of place? If there may be a back or neck injury, feel every vertebra (the knobs of the backbone) from the head to the space between the buttocks.
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See what to do for signs of head injury.
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If you suspect there may be an injury to the head, neck, or back, see "Spine and Neck Injuries" before you move the person.


This page was updated:17 Sep 2020