Managing an unresponsive adult casualty

Whether you are the trained first aider or not would you know what to do if you came across an injured casualty? It can take 8 minutes for an ambulance to arrive on the scene. If you have never had any training before but do find yourself in this situation we recommend you follow the NHS guidelines.

First step is always to call 999 to alert the emergency services and request an ambulance. You then must follow the following three priorities which are commonly referred to as ABC

  • Airway
  • Breathing
  • Circulation

If a casualty is unresponsive keep asking if they are okay and if they can open their eyes. IF they respond to you then you should leave them in the position they are in and await support. During this time continue to check breathing, pulse and responses.


IF they do NOT respond, with the casualty in the position they are in try and open their airway. If this is not possible gently move them on to their back and open their airway by placing one hand on the casualty’s forehead and gently tilting their head back, lifting the tip of the chin using two fingers. If you think the person may have a spinal injury, then you should place your hands on either side of their head and use fingertips to gently lift the angle of the jaw forward and upwards, without moving the head, to open the airway.Be careful NOT to move the casualty’s neck. Remember however, that opening the airway takes priority over a neck injury. This is known as the jaw thrust technique.


To understand if the casualty is breathing look to see if their chest is rising and falling. Listen over mouth and nose for any breathing sounds and place cheek over mouth and nose to feel if their is any breath on your cheek for 10 seconds. If they are breathing normally place into recovery position and await support. Continue to monitor their breathing.  If the casualty isn’t breathing call 999 and, if you can, begin CPR.


If the casualty isn’t breathing normally, then you MUST start chest compressions immediately. 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 shouldn’t be mistaken for normal breathing and CPR should be given straight away.

This information has been supplied by the NHS and is covered as part of our Emergency First Aid at Work course.


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