First aid: 6 life-saving steps if you're first on the scene of an accident
Please note that the information on this page is for general information only and does not qualify you as an official first aider. Virtual College always advises calling 999 in the first instance at the scene of an emergency.
The first person on the scene of an accident is unlikely to be a trained professional. However, they are still critical to the outcome for the people involved in the incident, and possibly for helping to recover casualties.
As a result, undergoing health and safety training and having a basic understanding of first aid protocol could prove life-saving.
At Virtual College, we have a range of health and safety e-learning courses designed to improve knowledge in this area, including first aid procedures.
If you're first on the scene of an incident, it may be useful to remember the DR(S) ABC acronym, as this stands for Danger, Response, Airway, Breathing and Circulation, as these six life-saving steps can be a significant help before the emergency services arrive.
Here, we're going to take a look at each of these six life-saving steps:
Step 1: Identify and mitigate potential dangers
The hazard involved in the accident could still be a danger to the casualty, as well as other people nearby, and even yourself as the first responder. You therefore need to make sure the area is safe before you begin administering first aid. For example, if it's a road traffic accident, you may need to try to block traffic, while if the incident involved a machine, it will need switching off.
Step 2: Call for help
Don't try to deal with the aftermath of an accident alone; the outcome is far more likely to be positive if you call for help. This means one person can give first aid, while another can halt traffic and call the emergency services. However, you should not leave the scene until you have determined the condition of any casualties.
Step 3: Check for a response
Check to see if the casualty is responsive by firstly talking to them loudly and clearly. If you do not receive a reply, gently shake their shoulders or give their earlobe a pinch to try to initiate a response. An earlobe pinch is likely to be the safest option if a severe bodily injury is suspected.
If you still do not receive a response, move onto step 4. If you are dealing with multiple casualties, those that appear unresponsive must take priority.
Step 4: Check the casualty's airway
If the casualty is responsive, you may be able to help them to clear their airway, but if they are not, you will need to place them into a position that ensures the airway is open.
To do this, gently place your hand on their forehead, tilting their head backwards to naturally open their mouth. Use two fingers from your other hand to lift their chin and create an unobstructed airway.
If a spinal injury is suspected, avoid tilting their head back. Instead, use two hands to carefully lift their jaw, which will help to clear their airway.
Step 5: Check the casualty is breathing
Once the airway is unobstructed, you need to check that the casualty is breathing normally, using one of the following methods:
- Listen to their chest and mouth to see if you can hear the casualty breathing
- Watch to see if the chest rises and falls normally
- Feel for breaths being taken by placing your cheek beside the casualty’s mouth
If the casualty is not breathing, call 999 immediately to request the emergency services. Chest compressions should then be given, as well as rescue breaths in accordance with CPR best practice if the responder is confident doing so. For more information, check out our guide on how to perform CPR in four easy steps here.
Step 6: Check the casualty's circulation
The final step in the first aid primary survey is to identify any major bleeding, which you should try to stem by applying pressure with your fingers or clothing. If it is a limb that is bleeding, raise it above heart level to reduce the flow of blood.
You must also make sure 999 has been called and try to prevent the casualty from going into shock, as knowing they are bleeding can make people panic.
If the casualty is responsive, you should also try to use the time before the emergency services arrive to establish more details about the incident, as this could be helpful when they do arrive, especially if the casualty later falls unconscious.
To learn more about first aid protocol, take a first aid e-learning course from Virtual College. Find out more here.
Related resources
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