Doctors Share Lifesaving Steps to Take During a Medical Emergency
Let’s say you’re out running errands or grabbing lunch between meetings. Suddenly, you’re jolted to attention by the sight of someone who has collapsed or is choking on their food. You want to help, but you’re not sure what to do.
This fraught scenario is all too common: A poll conducted by the American College of Emergency Physicians (ACEP) found that roughly 50% of people surveyed felt unprepared to help in emergency situations. But bystander intervention while waiting for emergency medical services to arrive (which takes an average of seven minutes after 911 is called) can be highly effective. And consider this: It’s not just strangers on the street who may benefit from life-saving measures – many medical emergencies happen at home, and the "bystander" is a family member.
In any medical emergency, always call 911 immediately. “This will not only get help on the way, but medical dispatchers are trained to guide callers through emergencies,” said ACEP spokesperson Puneet Gupta, M.D., assistant medical director for the Los Angeles County Fire Department and assistant clinical professor of medicine at UCLA.
There are many reasons people may hesitate to help in a medical crisis. “Some are afraid that they’ll end up harming the victim if they administer the wrong treatment or do it incorrectly,” explains Adam Z. Tobias, M.D., an associate professor of emergency medicine at the University of Pittsburgh School of Medicine. “But the reality is that some treatment is usually better than none, and in certain time-sensitive emergencies, there is actually very little a bystander could do to make things worse,” Dr. Tobias adds.
If you're worried you could get in legal trouble for helping out, keep this in mind: “Most states have some sort of ‘Good Samaritan’ law that covers bystanders who assist during emergencies,” notes Susan Bailey, president of the National Association of Emergency Medical Technicians (NAEMT) and director of the Louisiana Bureau of Emergency Medical Services. These laws vary from state to state and for each type of medical emergency. For example, 48 states and Washington, D.C., have laws protecting people who administer an overdose reversal drug in cases of suspected opioid overdose.
“For many time-sensitive emergencies, a few minutes can make a huge difference, and intervention by a bystander while awaiting the arrival of medical professionals can be the difference between life and death,” says Dr. Tobias.
Education is key: More than 90% of adults trained in any form of emergency response are willing to act during a medical crisis while waiting for EMS professionals to arrive, notes Matthew J. Levy, DO, a member of the American Red Cross Scientific Advisory Council and associate professor of emergency medicine and surgery at Johns Hopkins University School of Medicine.
Here are four common medical emergencies, how you can help with each one, and where to learn more so you feel prepared:
Cardiac arrest
More than 350,000 people experience out-of-hospital sudden cardiac arrest in the U.S. each year, and only 10% survive. Bystander CPR increases this rate to 30%, and the added use of an automated external defibrillator (AED) increases the survival rate to 50%. Performing hands-only CPR has been found to double or triple the odds of surviving cardiac arrest compared to no CPR. This approach can be used with teens and adults, while infants and most children should receive traditional CPR with rescue breaths.
What it looks like: When someone experiences cardiac arrest, the heart suddenly stops beating and they collapse to the ground and stop moving. They may stop breathing or start gasping for air, and they don’t respond to touch or talking – even yelling.
What to do:
Call 911 and grab an AED if you see one nearby (many public spaces, like theaters, schools, and airports, have them). If another bystander is around, have them call 911 and grab the AED.
Lay the victim on their back on a firm, flat surface, then kneel beside them and start hands-only CPR (for teens or adults). Aim to push down at least two inches in the center of the victim’s chest at a pace of roughly 100-120 pushes per minute (you can sing the Bee Gees’ classic “Stayin’ Alive” to get the right rhythm), allowing the chest to rise to the normal position between each push.
If an AED is on hand, turn it on and follow the audio prompts, then resume CPR and continue alternating between CPR and AED.
What not to do: Don’t stop rescue efforts until the person starts breathing, a pro rescuer takes over, the scene becomes unsafe, or you’re alone and become too exhausted to keep going.
Learn more: For a hands-only CPR demonstration, click on the American Red Cross YouTube Channel. The technique can be fully taught and practiced in less than an hour, said ACEP spokesperson Bret A. Nicks, M.D., professor and executive vice chair of emergency medicine at Wake Forest University School of Medicine. You can also look into taking classes..
Choking
Choking on food or another object is among the top causes of preventable injury-related death, and bystander rescue can save lives. In a 2024 study of patients admitted to the ER with foreign body airway obstruction, those who received bystander intervention before arrival were twice as likely to survive.
What it looks like: Someone whose airway is fully or partially blocked may appear panicked, surprised or confused, and may be clutching their throat with their hands. They may be unable to make any vocal sounds, or they may have a weak cough or make high-pitched squeaking noises. Their skin may turn pale and blue as the oxygen deprivation continues.
What to do:
Call 911 and find a safe spot (out of the way of traffic, for example) to provide aid.
If the person is conscious, deliver 5 back blows by hitting the heel of your hand between their shoulder blades.
If the back blows don’t do the job, switch to the Heimlich maneuver:
1.Stand behind the person and wrap your arms around their torso (if it’s a child, kneel behind them).
2. Make a fist with one hand and grab it with the other.
3. Place hands above their belly button, below their ribcage.
4. Thrust inward and upward. (If the victim is pregnant, chest thrusts should be given instead of abdominal thrusts.)Continue alternating between 5 back blows and 5 abdominal thrusts until the victim begins to cry, speak, or cough. If they become unresponsive, place them on a flat surface and start CPR while waiting for EMS.
At that point, if you can see the foreign object when you open the person’s mouth, remove it with your finger.
What not to do: Do not try to remove the foreign object if it’s firmly lodged or not visible or if the person is conscious. Also, if someone has inhaled an object but is able to speak, breathe, or cough fully, hold off on the rescue efforts and encourage them to keep coughing to try to dislodge the object.
Learn more: The American Red Cross provides more detailed instructions, a video demonstration, and training classes searchable by location.
Life-threatening bleeding
Bleeding results in nearly one-third of deaths from traumatic injuries, which represent the top cause of death for people younger than 44 years in the U.S. A program called Stop the Bleed teaches laypersons how to control life-threatening bleeding. In studies conducted in the U.S. and Sierra Leone, trainees who used Stop the Bleed techniques in subsequent medical emergencies saved lives in approximately 95 percent of cases.
What it looks like: Bleeding can be considered life-threatening if it’s flowing continuously or the amount of blood could fill about half a soda can –less in an infant or small child. The victim may also show signs of shock due to the blood loss, such as rapid breathing and cool, moist skin.
What to do:
Call 911
If you have been trained on the proper use of a tourniquet, that is the best method to control bleeding, Bailey says
For everyone else, the best strategy is putting pressure as hard as you can on the source of the bleeding until EMS arrives, Dr. Gupta says. To do this, find the source of the bleeding, place clean gauze or cloth on the wound, and apply direct, continuous pressure until the bleeding stops or EMS arrives.
What not to do: If the wound was caused by an object that’s still embedded in the person’s flesh, don’t try to remove it, as this could worsen the bleeding.
Learn more: The American College of Surgeons offers a free, 25-minute Stop the Bleed interactive web-based course that’s also available in a mobile-friendly version. Or you can search the Stop the Bleed class registry to find an in-person class in your area.
Opioid overdose
With the opioid epidemic claiming roughly 80,000 lives each year in the U.S., advocates encourage everyone to carry and learn how to use naloxone (also known as Narcan), which can reverse opioid overdose. Research has shown a 98% survival rate among individuals who received naloxone from bystanders during a suspected opioid overdose.
What it looks like: Some of the signs of opioid overdose include unconsciousness, slow or shallow breathing, choking or gurgling sounds, discolored skin, and constricted “pinpoint pupils.”
What to do:
Try to wake the person by shouting or shaking them and then rubbing your knuckles into their chest for 5 to 10 seconds.
Call 911 immediately if they won’t wake up, and if you suspect an overdose.
Administer intranasal or injectable naloxone. More than one dose may be needed.
If they remain unresponsive, start CPR. Turn them on their side to prevent choking and stay with them until help arrives.
What not to do: Don’t refrain from using naloxone if you’re unsure of whether an unconscious person is really having an overdose or which drugs they may have taken. Naloxone will have no effect on someone who doesn’t have opioids in their system.
Learn more: Watch quick demos from the Centers for Disease Control and Prevention on how to use intranasal and injectable naloxone. Many hospitals and organizations offer free naloxone kits and training, or you can buy the nasal spray version over the counter at pharmacies nationwide.
Other free and low-cost resources
In addition to bystander training courses for each of these scenarios, there are training programs that cover all the bases.
The American Red Cross partnered with ACEP to develop Until Help Arrives, a $40 course that teaches the general public how to respond to emergencies involving choking, cardiac arrest, life-threatening bleeding and opioid overdose.
The Red Cross also has a free first aid app that provides instructions for a range of common emergencies along with other resources.
“The NAEMT offers community education on various lifesaving measures, as well as the First On The Scene (FOTS) course to “teach laypeople basic responses to help in life-threatening emergencies until EMS arrives on the scene,” Bailey explains.
“We need for people to understand that even a little bit of help from a bystander could be enough to save someone's life in a medical emergency,” Dr. Tobias says.
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