Introduction

If a person does not respond to the sound of your voice or to gentle pressure applied to their body, it is likely they are unconscious.

Recognition and treatment

Step 1 of 10: Look for

To confirm if someone is unconscious and not breathing complete the steps of the primary survey - Danger, Response, Airway, Breathing (DRAB).

Step 2 of 10: Check for danger

• Are you or they in any danger?
• If you have not already done so make the area safe and then assess them
• If a person is drowning, only enter the water to rescue them if it is safe to do so, you have been trained to so, and they are unconscious. Dial 999/112 for emegency help immediately for drowning victims.

Step 3 of 10: Check for a response

• Shout a command at them:
  • 'Can you hear me?'
  • 'Open your eyes'
• Gently shake their shoulders
• If they respond, refer to the treatment for someone unconscious but breathing - children and adults
• Shout for help.

Step 4 of 10: Open the airway

• Help them to breath by opening their airway
• To do this, place one hand on the forehead and using two fingers lift the chin

Step 5 of 10: Check breathing

• Position your cheek close to their mouth
• Look, listen and feel for no more than 10 seconds:
  • look to see if the chest is rising and falling
  • listen for breathing
  • feel the breath against your cheek
• If they are not breathing commence cardiopulmonary resuscitation (CPR).

Step 6 of 10: Call for help

• If you have someone with you, send them to dial 999 (or 112) for an ambulance immediately
• If unconsciousness is due to drowning, you should give five initial rescue breaths and perform CPR for one minute before making the call
• If you are on your own, carry out CPR for one minute before dialling 999 (or 112) for an ambulance.

Step 7 of 10: Position the AED beside them

Remove medication patches and metal jewellery from the unconscious person. This should not delay the application of the AED.

Step 8 of 10: Turn on the AED and follow the voice prompts

• Remove the electrode pads from their sealed packets
• Place them on the unconscious person's bare chest following the instructions given with the pads.

Step 9 of 10: Shock if required

• The voice prompts will instruct you not to touch the unconscious person
• Instruct everyone to stand clear
• Any CPR being performed should stop
• Check that no one is touching the unconscious person.
• The AED now analyses their heart rhythm
• If they need to have shocks, the AED will charge and issue a voice prompt:
  • before giving the shock, double check that everyone is clear of the unconscious person by giving a second command to 'stand clear'
  • look to make sure everyone is clear
  • press the 'Shock' button on the AED
  • when the shock is delivered the unconscious person will jump - this is normal.

Step 10 of 10: Continue

• Keep following the voice prompts issued by the AED
• Do not give up if the first shock seems ineffective.
• Do not stop unless:
  • emergency help arrives and takes over
  • they show signs of recovery such as coughing, opening eyes, speaking or moving purposefully and breathing normally
  • you become so exhausted that you cannot carry on.

More information using an automated external defib (AED)

An automated external defibrillator (AED) detects and analyses life threatening heart rhythms. If such a rhythm is detected it is capable of delivering a shock to defibrilate the heart, allowing the heart to restart a normal rhythm.

AEDs are designed to be used by both trained and untrained people using voice prompts to advise what steps to take.

Combining an AED with chest compressions and rescue breaths (together known as cardiopulmonary resuscitation) is the most effective treatment for an unconscious not breathing person.

Unable, unwilling or untrained to give rescue breaths

• Give chest compressions only and continue at a rate of 100-120 per minute (about the speed of the song 'Nelly the Elephant').

Two trained rescuers

• Change every two minutes with minimal disruption.

Agonal breathing

This is common in the first few minutes after a sudden cardiac arrest. It usually takes the form of sudden irregular gasps for breath. It should not be mistaken for normal breathing and if it is present chest compressions and rescue breaths should be started without hesitation.