First aid basics cover five situations: an unresponsive but breathing person, someone who has stopped breathing, severe bleeding, choking, and burns. Health bodies including St John Ambulance (UK) and the World Health Organization say bystanders acting in the first minutes of an emergency can affect the outcome before professional help arrives. This guide summarizes the step-by-step actions recommended by these organizations — it is not a substitute for a certified first aid course.
Before trained paramedics arrive, a bystander is often the only person who can act. The World Health Organization (WHO) says communities have "an important role in the early recognition of danger signs, delivery of first aid and initiation of movement to more definitive care," a principle formally endorsed by the World Health Assembly in resolution 76.2. The steps below are drawn from guidance published by St John Ambulance, the UK first aid charity, and from WHO's community emergency care materials. They describe general first aid for adults and are not a replacement for a certified course or professional medical treatment.
Check the scene, then check the person
St John Ambulance guidance starts every emergency response the same way: make sure the scene is safe to approach, then check if the person responds by gently shaking their shoulders and asking loudly if they are okay. If there is no response, the next step is to open the airway — tilting the head back and lifting the chin — and look, listen and feel for normal breathing for up to 10 seconds, ignoring occasional gasps, which are not normal breathing.
Unresponsive but breathing normally: the recovery position
If the person does not respond but is breathing normally, St John Ambulance advises placing them in the recovery position to keep the airway open and let any vomit drain away rather than block breathing.
Kneel beside the person, straighten their legs, and remove glasses or bulky items from their pockets.
Place the arm nearest you at a right angle to the body, elbow bent, palm facing up.
Bring the other arm across the chest and hold the back of that hand against the cheek nearest you.
With your other hand, pull the far knee up so the foot is flat on the floor.
Keeping the hand pressed to the cheek, pull the far leg to roll the person onto their side, then bend the top leg to a right angle.
Tilt the head back and lift the chin to keep the airway open.
Call 999 or 112 (or the local emergency number) if this has not already been done, and monitor the person until help arrives.
St John Ambulance adds that if the person stays in the recovery position for 30 minutes, they should be rolled onto the other side, and that for a suspected spinal injury, the head and spine should be kept as aligned as possible while still opening the airway.
Not breathing: CPR
If the person is unresponsive and not breathing normally, St John Ambulance says to call emergency services immediately — ideally asking a helper to call while CPR begins, or using a phone's speaker function to stay on the line while compressing the chest.
Kneel close to the person and place the heel of one hand on the middle of the chest.
Place the other hand on top and interlock the fingers if possible.
Lean forward so your shoulders are directly over your hands, keep your arms straight, and press down hard to a depth of about 5–6 cm (roughly 2 inches).
Compress at a rate of 100 to 120 compressions per minute.
After 30 compressions, give 2 rescue breaths if trained to do so, then continue the 30:2 cycle.
Continue until emergency help arrives, the person starts breathing normally, you are too exhausted to continue, or a defibrillator (AED) becomes available and ready to use.
St John Ambulance's guidance also notes that a defibrillator should be requested as soon as possible and used as soon as it is available.
Choking: back blows and abdominal thrusts
According to St John Ambulance, a choking person who can still cough, speak, or make noise should be encouraged to keep coughing, since this may clear the obstruction on its own. If they cannot breathe, cough, or make a sound, the following sequence applies.
Help the person lean forward, supporting their upper body with one hand.
With the heel of your other hand, give up to five sharp back blows between the shoulder blades, checking the mouth after each one for a dislodged object.
If that does not work, stand behind the person, wrap your arms around their waist, and place a clenched fist between the belly button and the bottom of the chest.
Grasp that fist with your other hand and pull sharply inward and upward up to five times, checking the mouth after each thrust.
If the blockage still has not cleared, call 999 or 112 for emergency help and keep repeating five back blows and five abdominal thrusts until help arrives.
If the person becomes unresponsive at any point, prepare to start CPR.
Severe bleeding: pressure first
For life-threatening external bleeding, St John Ambulance's core instruction is that stopping the bleeding is the priority. Firm pressure should be applied with a sterile dressing or clean cloth; if an object is embedded in the wound, it should not be removed, and pressure should instead be applied on either side of it to bring the wound edges together.
Call 999 or 112 immediately and describe the location and severity of the bleeding.
Secure the dressing firmly, but not so tightly that it cuts off circulation — check circulation beyond the bandage roughly every 10 minutes by pressing a nail or skin until it turns pale and confirming colour returns within about two seconds.
Help the person lie down with legs raised above heart level, loosen tight clothing, and keep them warm to reduce the risk of shock.
If blood soaks through the dressing, remove it and reapply a fresh pad with pressure rather than stacking dressings.
A tourniquet, improvised if necessary from items such as a triangular bandage or belt, may be used if direct pressure does not control the bleeding — emergency call handlers can advise on this.
Keep monitoring the person's responsiveness and be ready to start CPR if they become unresponsive.
Burns and scalds: cool, don't ice
St John Ambulance says the priority for a burn or scald is to start cooling it as quickly as possible, under cool running water, for at least 20 minutes or until the pain eases. If water is not available, cold milk or canned drinks can be used instead.
Do not use ice, creams, or gels on a burn, as these can cause further tissue damage and raise infection risk.
Do not burst any blisters that form.
Remove jewellery or clothing near the burn before swelling starts, unless it is stuck to the skin.
Once cooled, cover the burn loosely — lengthways, not wrapped in circles — with cling film or, for hands and feet, a clean plastic bag.
Monitor the person and seek medical advice, since cooling is first aid, not a substitute for professional treatment of a significant burn.
Why bystander action matters
WHO's community emergency care guidance states that World Health Assembly resolution 76.2 underscores "the critical role of community-level responders in strengthening integrated emergency, critical and operative care." WHO also notes that in conflict-affected or landmine-affected areas, organized community first-responder programs have been shown to reduce preventable deaths by enabling a timely, organized initial response, though the organization does not publish a single global figure for lives saved through bystander first aid generally.
The community has an important role in the early recognition of danger signs, delivery of first aid and initiation of movement to more definitive care.
— World Health Organization, community-based emergency care guidance
Limits of this guide
These steps summarize publicly published first aid guidance for general awareness. They do not cover every scenario — such as choking or CPR in infants and children, which follow different techniques — and they are not a substitute for a certified first aid and CPR course, which includes supervised practice. St John Ambulance and national Red Cross societies, among other organizations, run such courses.
Questions
What are the first three things to do in any emergency?
According to St John Ambulance, check that the scene is safe, check whether the person responds by gently shaking their shoulders and speaking to them, and then open the airway and check for normal breathing for up to 10 seconds.
How deep and how fast should chest compressions be during CPR?
St John Ambulance guidance states compressions should be about 5–6 cm deep at a rate of 100 to 120 per minute, following a cycle of 30 compressions to 2 rescue breaths if trained to give breaths.
How long should a burn be cooled under water?
St John Ambulance recommends cooling a burn or scald under cool running water for at least 20 minutes, or until the pain eases, and warns against using ice, creams or gels.
What should I do if someone is choking and cannot speak or cough?
St John Ambulance advises giving up to five sharp back blows between the shoulder blades, checking the mouth after each one, and if that fails, up to five abdominal thrusts, repeating the cycle and calling emergency services if the blockage does not clear.
When should a tourniquet be used for bleeding?
St John Ambulance states a tourniquet, improvised if necessary, can be used if direct pressure on a wound does not control life-threatening bleeding, and notes that emergency call handlers can give guidance on this during the call.
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