Our A&E departments are overwhelmed with casualties; ambulances are struggling to cope and may be unable to get to you quickly; we can all do our bit to help.

Understand when you need an ambulance:

A&E crisis - how you can help

Administer appropriate First Aid and call an ambulance immediately: If someone has an accident or illness and is experiencing any of the following;

  • Appears not to be breathing
  • Has been experiencing chest pain for more than 5 minutes, was woken by chest pain or it has come on whilst they are at rest
  • If they have difficulty breathing or experiencing weakness, numbness or difficulty speaking
  • Have severe bleeding that you are unable to stop with direct pressure on the wound
  • Are struggling for breath, possibly breathing in a strange way appearing to ‘suck in’ below their rib cage and using other muscles to help them to breathe.
  • Are unconscious or unaware of what is going on around them
  • Have a fit for the first time, even if they seem to recover from it later
  • If they are having a severe allergic reaction accompanied by difficulty in breathing or collapse
  • If they are burnt and the burn is severe enough that you think it will need dressing – treat the burn under cool running water and call an ambulance. Keep cooling the burn until the paramedics arrive – look out and treat signs of shock.
  • If they have fallen from a height, been hit by something travelling at speed (like a car) or been hit with force whilst doing combat or contact sport and there is a possibility of a spinal injury.  If they are conscious; encourage them to keep still; if unconscious and breathing – roll into the recovery position without twisting them (log roll if possible)

 Drive or get a taxi straight to A&E if they have:

A&E crisis - how you can help

  • Severe abdominal pain
  • A cut that is gaping or losing a lot of blood, if they have amputated a finger or if there is something embedded in the wound. (Apply direct pressure first and call an ambulance and position with legs raised if they show signs of shock)
  • A leg or arm injury and can’t use the limb
  • Swallowed poison or tablets and are not showing any adverse effects (111 can also give you advise from the poisons database – if they are behaving strangely or experiencing any symptoms from the poison; call an ambulance immediately)

Family Doctor: For other less serious and non life-threatening medical concerns, contact your GP or phone 111 for medical advice

Specific advice for babies: Always be more cautious with babies


If a baby is experiencing the following symptoms call an ambulance immediately:

• A high-pitched, weak or continuous cry.

• A lack of responsiveness, lethargy or floppiness, change in colour, blue, mottled or ashen.

• A bulging fontanel (the soft spot on a baby’s head – particularly following a head injury or if they are unwell).

• Not drinking for more than eight hours (taking solid food is not as important).

• A temperature of over 38°C if the baby is less than three months old or over 39°C if the baby is three to six months old or a raised temperature that you are unable to bring down.

• A high temperature, with cold feet and hands.

Most importantly – trust your instincts. If you are seriously worried, administer First Aid and get medical help quickly.


Learn how to help whilst waiting for an ambulance:

A&E crisis - how you can help

Danger – do not put yourself at risk

Response – are they conscious?

Airway – if unconscious – open their airway

Breathing – check for at least 2 normal breaths in a 10 second period

Circulation / CPR – if unconscious and not breathing start CPR

The life threatening priorities are:

Breathing – if you do not protect their airway and they are not breathing they are dead!

Bleeding – if you see blood; apply direct pressure and be aware of signs of shock that could indicate internal bleeding.

Burns – Burns can be dangerous as people lose a lot of fluid and can go into shock; burns are painful and prone to infection. All burns should be assessed by a medical professional

Broken bones – don’t be distracted by broken bones as they are rarely life threatening.

If the casualty is conscious –

  • Keep yourself and the casualty calm.
  • Check that they have no problems breathing and control any bleeding with direct pressure.
  • Keep them warm and dry.

If the casualty is struggling to breathe, the best position for them to be in is sitting down in an upright position. Try and establish why they are having difficulty and if they have any medication to help – are they asthmatic? Could they be having an acute allergic reaction? – if so help them to administer any medication straight away. If their condition doesn’t improve, phone the ambulance service again and tell them what is happening.

If you think they might be showing signs of a heart attack – sit them down in an upright position (lazy W if they are comfortable with this) and encourage them to take their GTN spray if they have one. If they do not feel better and they have been prescribed a 300mg aspirin they should chew this – phone the emergency services and stress that it is urgent. If they become unconscious and stop breathing – start CPR.

If someone is showing signs of a stroke – get them to a stroke unit as soon as you can. If there is a delay with the ambulance and you feel safe transporting them, take them there yourself. It is of critical importance that they are swiftly assessed as if they have a blood clot and are treated quickly enough it is possible to reverse the damage.

If they are unconscious and breathing they must be put into the recovery position to protect their airway from vomit and from their tongue flopping back and causing and obstruction.

It is strongly advised that you attend a Practical First Aid course to understand what to do in a medical emergency. Please visit firstaidforlife.org.uk emma@firstaidforlife.org.uk or tel: 0208 675 4036 for more information about our courses. First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.

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