Basic First Aid for Emergencies: CPR, Choking, Bleeding, Burns and Shock

A neighbour collapses in the society lift lobby. A child chokes on a peanut at a wedding. A worker cuts his arm badly on a sheet of metal. The ambulance will come, but the first few minutes are in your hands, and what you do in them can decide whether the person lives.

You do not need to be a doctor. You need to keep yourself safe, call for help early and know a handful of simple steps. Here they are.

First, check for danger

• Look before you rush in. Traffic, live wires, fire, gas or a falling structure can make you the second casualty. Only go in when the scene is safe for you and the person.
• Check the person. Speak loudly and tap their shoulders. See whether they respond and whether they are breathing normally.
• Call early. If they do not respond, call 112 (or 108 for an ambulance) straight away. Put the phone on loudspeaker so you can follow the call handler’s instructions with your hands free.

Which number to call in India

Call 112 for any emergency. It reaches the emergency response centre in your state, and the operator sends the police, a fire tender or an ambulance. 108 is the ambulance number in most states and UTs, for medical emergencies and accidents. If one does not connect, try the other. For medicine, pesticide or a household chemical swallowed by mistake, the National Poisons Information Centre at AIIMS, Delhi, has a toll-free line, 1800 116 117, open round the clock. Say where you are first and stay on the line. Our guides to emergency numbers in India and what to say when you call cover the rest.

CPR when someone collapses

Start CPR if the person does not respond and is not breathing normally. Occasional gasps are not normal breathing.

1. Call for help. Call 112 and ask someone to bring an AED (defibrillator) if there is one nearby.
2. Place your hands. Put the heel of one hand in the centre of the chest, the other hand on top, and lock your fingers together.
3. Push hard and fast. Press straight down at least 5 cm but not more than 6 cm, at 100 to 120 compressions a minute, with as few pauses as possible.
4. Rescue breaths only if trained. If you have been trained, give 2 breaths after every 30 compressions: tilt the head back, lift the chin and breathe in just enough to make the chest start to rise. If you have not been trained, keep doing chest compressions without stopping.
5. Use the AED. Switch it on as soon as it arrives and follow its voice prompts. Keep going until the AED tells you to stop, a medical team takes over or the person shows signs of life.

Hands-only CPR is meant for adults who collapse suddenly. For a child, or for someone who has drowned or been poisoned, breaths matter as much as compressions, so give them if you have been trained. If you have not, compressions alone are still far better than doing nothing. Do not stop to look for a pulse. If someone else is with you, swap every two minutes so the pushing stays strong. Ribs sometimes crack during good CPR; that is not a reason to stop. More in our guides to hands-only CPR and CPR myths.

Choking

Act when the person is choking and cannot breathe, speak or cough properly.

1. Get them coughing. If they can still breathe or talk, tell them to keep coughing. That is often enough to clear it.
2. Back blows. If they cannot cough, speak or breathe, lean them forward and give up to five firm blows between the shoulder blades with the heel of your hand.
3. Abdominal thrusts. If that fails, stand behind them, put a fist between the navel and the bottom of the breastbone, hold it with your other hand and give up to five sharp pulls inwards and upwards.
4. Keep going and call. If the blockage has not cleared, call 112 and repeat the back blows and thrusts. If they go unresponsive, start CPR.

Babies under one year need back blows and chest thrusts instead, not abdominal thrusts.

After each back blow or thrust, look in the mouth and take out anything you can see, but do not poke around blindly with your fingers. A child needs gentler blows than an adult, and a baby needs a different method altogether, so please learn it in a practical course rather than from a page. Our guide to emergencies in children is a good place to start. For the full steps for an adult, a child and a baby, and how to prevent choking at weddings and festivals, see our guide to choking in an adult, child or baby.

Heavy bleeding

• Press on it. Press firmly on the wound with a sterile dressing or a clean cloth that will not shed fluff. Call 112 for severe bleeding.
• Leave anything stuck in the wound. Do not pull out glass, metal or a stick. Press on either side of it instead.
• Do not let go. Keep the pressure on until the bleeding stops or help arrives. If blood soaks through, leave the dressing where it is and press a fresh pad on top.
• Bandage it firmly. Once the bleeding slows, bandage the pad in place, but not so tight that fingers or toes turn pale or cold. Check them every ten minutes or so.
• A tourniquet is a last resort. It is only for heavy bleeding from an arm or leg that pressure cannot control, and only if you have been trained or the call handler tells you to use one. Do not loosen it yourself. Our road accident first aid guide says more.

Burns

Cool the burn under cool, clean running water for 20 minutes. No ice, toothpaste, oil or butter. Our burns and scalds first aid page goes through hot oil, steam, chemical and electric burns step by step.

• Take off rings, bangles, watches or clothing near the burn, unless they are stuck to the skin.
• Once the burn is cooled, cover it loosely with cling film laid lengthways, or a clean plastic bag for a hand or foot.
• Do not burst blisters. Do not put creams, gels, haldi, ghee or any other home remedy on it.
• Get medical advice. Call 112 for a large or deep burn, a burn on a child, a burn on the face, hands or genitals, or any burn from electricity or chemicals. Smoke from a fire in a closed room can also hurt the airway, so see a doctor even if the skin looks fine.
• If clothes are on fire, stop the person from running, lay them on the ground and smother the flames with a blanket or coat. Then cool the burn as above. Two common causes at home are covered in our guides to Diwali burns and pressure cooker accidents.

Broken bones and sprains

• Keep them still. Support the injured part by holding the joints above and below it, and pad around it. Do not move the person unless they are in immediate danger.
• Cover open wounds. If there is a wound or bone is showing, cover it with a sterile dressing or clean cloth and press around the wound, not on the bone.
• Know when to call 112. Call for an open fracture, a suspected broken thigh or other long bone, or a suspected back, neck or pelvis injury. Any other suspected fracture still needs a hospital check.

Shock

Shock can follow a serious injury or heavy blood loss. The person may look pale, feel cold and clammy, and breathe fast.

• Treat the cause and call 112. Control any heavy bleeding, help the person lie down and, if it does not hurt them, raise and support their legs. Tell the call handler you think they are in shock.
• Keep them warm. Cover them with a blanket or a shawl.
• Stay with them. Loosen tight clothing, talk to them calmly and keep checking how they respond. If they stop responding and are not breathing normally, start CPR.

Other emergencies in short

• Electric shock. Switch off the power at the mains or MCB first, and do not touch the person while they are still in contact with the current. If you cannot switch it off, stand on something dry and push them clear with a dry wooden stick or broom handle. Stay away from a fallen high-tension wire and call 112. Anyone who has had a shock needs a doctor. Details: how to rescue someone from electric shock safely.
• Heart attack or stroke. Chest pressure or pain, pain spreading to the arm, jaw or back, a cold sweat, or a drooping face, weak arm and slurred speech: call 112 at once and keep the person resting. Do not let them drive themselves, and do not give any medicine unless the call handler or a doctor says so. Details: heart attack and stroke.
• Fits (seizure). Cushion the head, loosen tight clothes, clear the space and note the time. Put nothing in the mouth, do not hold the person down, and give no food or drink until they are fully awake. When the shaking stops, turn them on their side. Call 112 if it is their first fit, lasts more than five minutes, they do not wake up properly, are hurt or have trouble breathing.
• Heatstroke. Hot skin, confusion, fast breathing or fainting after heat is an emergency. Call 112 or 108, move the person to shade or a cool room, and cool the skin with wet cloths, a fan or cool water. Give water in small sips only if they are fully awake. Details: heatstroke and heat exhaustion.
• Snakebite and dog bite. After a snakebite, keep the person calm and still, hold the bitten limb still, and get to a hospital that has anti-snake venom without delay. Do not tie a tight band, cut the wound or suck it, and do not lose time with a local healer. For a dog bite, wash the wound with soap under running water for 15 minutes and see a doctor the same day for rabies care. Details: snakebite first aid and dog bite first aid.
• Drowning. Do not jump in after the person unless you are trained. Shout for help, throw a rope or anything that floats, and call 112. Once the person is out and not breathing normally, start CPR, with breaths if you are trained. Details: how to save a drowning person without risking your own life.
• Swallowed medicine or a chemical. Do not make the person vomit, and do not give food, drink or any home remedy unless the poison centre or a doctor says so. Call 1800 116 117 or 112, and keep the packet to show. Details: medicines at home.

What to keep in a first-aid kit

A tidy box in the kitchen or hall is better than a drawer of loose strips. Put in sterile dressings and gauze pads in a few sizes, a roll bandage and a triangular bandage, adhesive plasters, medical tape, blunt scissors, tweezers, disposable gloves, antiseptic wipes, a foil blanket, cling film for burns and a small torch. Add ORS sachets, a digital thermometer and any medicine a doctor has prescribed for someone in the family, with their names written on the box. Check it every six months and throw out anything that is expired or damp. We have not listed painkillers or other tablets, because the right ones and the doses depend on the person; ask your doctor. Our home emergency kit checklist covers the rest of what a family needs.

Learn it properly

Reading this page helps, but your hands need practice. Book a practical first-aid and CPR course with the Indian Red Cross Society, St John Ambulance or a trained provider near you. Then save 112 and the other emergency numbers in your phone, find out where the nearest AED is kept in your office or society, and check that your first-aid kit is stocked. For the first minutes at the scene, read our guide to safe bystander action.