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Accidents and first aid

Introduction

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 at the scene of the accident 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 accident.

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.

If someone is unconscious and not breathing

If a person is not breathing normally after an accident, call for an ambulance and then, if you can, start CPR straight away. Read more about CPR, including instructions 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 and the British Red Cross both 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 epinephrine on them. This is a kind of adrenaline and usually comes in a 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 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 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 department (A&E).

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.
  • Remove any obvious obstruction from the mouth using your first two fingers and thumb.

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 health professional afterwards to check for any injuries caused by abdominal thrusts or any smaller pieces of the obstruction that remain.

What to do if a baby is choking.

If a baby is choking, you need to assess the situation quickly to see how best you can help. This information applies to babies aged under one year old.Choking happens when a person’s airway suddenly gets blocked so they cannot breathe. Their airway can be partly or fully blocked. In babies, choking is often caused if they put small objects in their mouths, which then get stuck. It can also be caused by food getting stuck.

Choking in babies under one year old

A baby who is choking will be distressed and may be unable to cry, cough or breathe.

  • Lie the baby face down along your forearm or thigh, with their head low. Support their head.
  • Give up to five firm slaps to the baby’s back between the shoulder blades with the heel of your hand. (The heel is between the palm of your hand and your wrist.)
  • Stop after each slap to check if the blockage has cleared. Look inside the baby’s mouth and remove any obvious blockage. Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage. You may push it further in.
  • If the airway is still blocked, give up to five chest thrusts (see below).
  • Stop after each thrust to check if the blockage has cleared.

If the baby’s airway is still blocked after three cycles of back slaps and chest thrusts, you should:.

  • dial 999 (or 112) for an ambulance immediately. Do not leave the baby. Take him or her with you to the phone 
  • continue with the cycles of back slaps and chest thrusts until help arrives

Chest thrusts for babies under one year old

In babies under one year old, chest thrusts are used in an emergency to clear a blockage from their airway. Important: do not use abdominal thrusts with babies under one year old.

  • Lie the baby along your forearm on their back, with their head low. Support their back and head.
  • Give up to five chest thrusts. Using two fingers, push inwards and upwards (towards the head) against the baby’s breastbone, one finger's breadth below the nipple line.
  • Check if the blockage has cleared after each thrust, by looking inside the baby’s mouth and removing any obvious blockage. Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage as you may push it further in. 

Complications

Once the baby’s airway is cleared, some of the material that caused the blockage can sometimes remain and cause complications later. If the baby still has a persistent cough or difficulty swallowing, they need to see a health professional urgently. You should take the baby to A&E or your GP if it’s during GP hours.

Drowning

Once the person is on land, if they are not breathing, 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, put them in 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:

  • 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.
  • Do not go near or touch the person until you are sure any electrical supply has been cut off.
  • 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 should be dealt with first.

If the person is conscious, prevent any further injury by keeping them 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 spine or leg, call for an ambulance.

  • Support the limb. 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.
  • Get them to hospital, either by driving them yourself (if they have a minor fracture) or 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

A 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 possible in the "W" position (sitting up with the knees bent).

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

Being poisoned is potentially life threatening. Most cases of poisoning in the UK occur when a person has swallowed a toxic substance such as bleach, prescription drugs or wild plants and fungi.

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 induce vomiting. 

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, put them in 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.

Read more information about treating someone who has been poisoned.

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 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.

Stroke

FAST 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

Getting help in an emergency:

999 has been the emergency services number in the UK for many years. But you can now also call 112 to get help.

112 is the single emergency telephone number for the European Union and will get you through to the emergency services wherever you are in the EU.

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After an accident

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 chin using two fingers. This is to move the tongue away from the back of the mouth.

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 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 for breathing and check if you can 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 a combination of chest compressions and rescue breaths (CPR). 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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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:

  • Roll a person on their side with their arms and upper leg at right angles to the body to support them.
  • Tuck their upper hand under the side of their head so that their head is on the back of the hand.
  • Open their airway by tilting the head back and lifting the chin.
  • Monitor their breathing and pulse continuously.
  • 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 in danger of further injury), you need someone else to help you roll them.

One person should be at the head and another along the side of the injured person. Work together to keep the person's head, neck and back aligned while gently rolling the person onto one side.

The recovery position for babies

For babies less than a year old, a different recovery position is needed. Cradle the infant in your arms with their head tilted downwards to make sure they do not choke on their tongue or vomit.

Until help arrives, keep checking the baby's vital signs, such as their temperature, pulse and whether they are breathing.

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CPR

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. Using your body weight (not just your arms), press straight down by 5–6cm on their chest.
  3. Repeat this until an ambulance arrives.

Try to give 100 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

Adults

  1. Place your hands on the centre of the person's chest and, with the heel of your hand, press down by 5–6cm at a steady rate, slightly faster than one compression a second.
  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, each over one second.
  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 their 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 your hands on the centre of their chest and, with the heel of your hand, press down by one-third of the depth of the chest using one or two hands.
  4. After every 30 chest compressions at a steady rate (slightly faster than one compression a second), 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. After 30 chest compressions at a steady rate (slightly faster than one compression a second), give two breaths.
  4. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

Watch Vinnie Jones perform hands-only CPR to the beat of Stayin' Alive. CPR is not as hard as you may think. Just call 999 and then push Hard and Fast. This video can be found on the website of the British Heart Foundation.

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