Is she awake? Is she breathing?
Check whether someone responds, open their airway, and spend no more than ten seconds deciding whether they are breathing normally.
Check for a response
- Kneel beside them
Get down close, level with their shoulders.
- Shake gently and shout
Hands on both shoulders, a gentle shake, and loudly: "Are you all right? Open your eyes." For a child, the same. For a baby, tap the foot instead; never shake a baby.
- If they answer or move
Leave them in the position you found them, if that's safe. Find out what's wrong, get help if needed, and check on them again regularly.
- If there's no response
Shout for help. Send someone to call the emergency number and someone else to find an AED. If you're alone, call yourself on speaker.
Check yourself
In a park, Kian finds a man lying on a bench. When Kian shakes his shoulders and asks if he's all right, the man groans and opens his eyes. The spot is safe. What now?
- Start CPR straight away
- Leave him as he is, ask what's wrong, get help if needed and keep checking on him
- Sit him up and give him some water
- Walk away, since he's awake
Show the answer
Leave him as he is, ask what's wrong, get help if needed and keep checking on him
Yes. He responds, so he doesn't need CPR. Leaving him as found (where it's safe), finding out what's wrong, getting help and rechecking is exactly the plan.
A IS FOR AIRWAY
Head tilt, chin lift
In someone who is unconscious, the muscles go slack and the tongue can fall back and block the airway. You open it in one move. Turn them onto their back. Put one hand on the forehead and two fingertips under the bony part of the chin. Gently tilt the head back and lift the chin. This pulls the tongue forward, off the back of the throat, so air can get through.
Press on the bone of the chin, not the soft skin under it: pressing the soft part pushes the tongue back into the way.
A door that swings shut
Think of the tongue as a heavy door hinged at the front of the mouth. When someone is awake, their muscles hold it open. When they're unconscious and on their back, gravity swings it shut against the back of the throat. Tilting the head and lifting the chin props the door open again. Where the analogy breaks: the door can swing shut again, so an unconscious person's airway needs watching, not a single fix.
Check yourself
With the airway open, you look, listen and feel for breathing. How long should that check take?
- No more than 10 seconds
- About 30 seconds, to be sure
- A full minute
- As long as it takes to be completely certain
Show the answer
No more than 10 seconds
Right. Ten seconds at most. If you still aren't sure after that, treat it as not breathing normally and act.
Breathing is not the same as breathing normally
Not normal: occasional gasps
A gasp every few seconds, slow, noisy or irregular, sometimes like a snore or a sigh. It can look like breathing, but it is not normal. It happens in the first minutes of many cardiac arrests. Call and start CPR.
Normal breathing
Regular, fairly quiet, with the chest rising and falling steadily. Unresponsive and breathing like this? Recovery position (lesson 03), and make sure help is called.
Agonal breathing
Occasional, gasping, often noisy breaths that can happen when the heart has stopped pumping effectively. They are a reflex, not real breathing, and they are one of the reasons bystanders wait when they shouldn't. Unresponsive with gasps = not breathing normally. A few seconds of brief, jerky, seizure-like movements can also happen at the start of a cardiac arrest.
"He was still breathing, so we waited." Often what the family saw were gasps.
Check yourself
At a family lunch, Maryam's uncle slumps in his chair. On the floor he doesn't respond, and with his airway open he takes one noisy gasp about every 10 seconds. What should Maryam do?
- Wait a minute to see whether he comes round
- Put him in the recovery position because he is breathing
- Treat it as not breathing normally: get 115 called and start CPR
- Check his pulse first
Show the answer
Treat it as not breathing normally: get 115 called and start CPR
Right. One noisy gasp every 10 seconds is not normal breathing. Unresponsive and not breathing normally means call and start CPR (lesson 04), with an AED as soon as one arrives.
Check yourself
Lay rescuers should check for a pulse before they start CPR.
Show the answer
False
False. Pulse checks by untrained people are unreliable and waste time. Unresponsive and not breathing normally is the whole signal: call and start CPR.
Check yourself
- Leila finds her neighbour on the stairs. He doesn't respond. With his airway open, his chest rises and falls regularly and quietly. She puts him in the recovery position and calls 115.
- Leila finds her neighbour on the stairs. He doesn't respond. With his airway open, he gives a loud gasp now and then, with long pauses between. She calls 115 on speaker and starts CPR.
Both men are unresponsive and both are doing something that looks like breathing. What decides Leila's next step?
- How loud the breaths are
- Whether the breathing is normal, not whether there is any breathing at all
- How old the neighbour is
- Whether he fell or sat down
Show the answer
Whether the breathing is normal, not whether there is any breathing at all
Exactly. Regular, quiet breathing means recovery position. Occasional gasps are not normal breathing, so it's CPR. The question is never just "is he breathing?" but "is he breathing normally?"
Check yourself
Daniyal finds a woman lying still in a shop doorway, and the scene is safe. In what order should he go?
- Tilt her head and lift her chin, look and listen, shake and shout, shout for help
- Shake and shout, shout for help, tilt the head and lift the chin, look, listen and feel
- Shout for help, look, listen and feel, shake and shout, tilt the head
- Look, listen and feel, shake and shout, tilt the head, shout for help
Show the answer
Shake and shout, shout for help, tilt the head and lift the chin, look, listen and feel
Yes: response first, then get help on its way, then open the airway and check breathing for no more than 10 seconds. That's the R, the call, the A and the B.
Lesson recap
- The order: Danger → Response → call for help → Airway → Breathing (DR ABC).
- Response: shake the shoulders gently and ask loudly. Babies: tap the foot, never shake. If they respond, leave them as found if safe and keep checking.
- No response: shout for help, send for the emergency number and an AED, then tilt the head and lift the chin.
- Look, listen and feel for no more than 10 seconds. Occasional gasps are not normal breathing. No pulse check.
- Unresponsive and breathing normally: recovery position. Unresponsive and not breathing normally, or unsure: call and start CPR.