When a casualty is unresponsive they may or may not be breathing. There could be injuries present which the casualty will be unable to communicate to you about, and their airway could also be compromised in the unresponsive state. 

Primary Survey


The first action once the area is declared safe is to check the casualty’s breathing whilst at the same time opening their airway. If you are unsure how to do this remember the DRABCD acronym. Look, listen and feel for signs of breathing for a maximum of 10 seconds.

If not breathing, proceed straight into Cardio Pulmonary Resuscitation (CPR). When breathing proceed to the secondary assessment.

Remember - Always clear the mouth of objects, blood and vomit before fully opening the airway

Secondary Assessment


Once it has been ascertained the casualty is breathing the next step is to try to establish what injuries / illness they may have. The top-to-toe survey can be used to check the whole of the body. Remembering the below priority points:
  1. Breathing / airway
  2. Major bleeding
  3. Fractures / dislocations & burns
  4. All other conditions
Check the casualty’s wrists and neck to see if they are wearing any medical identity bracelets. This could also be in their purse / wallet. For example: It would be very unusual if a known diabetic was lying unresponsive, with no injuries and this was unrelated to their diabetes. 

Helpful hint - Also think about spinal / head injuries in road traffic incidents and from any fall from height

Recovery Position


The recovery position should be completed after the secondary survey. This is because moving them could make their condition worse if they, for example had a suspected major head or spinal injury.

You can watch this tutorial video if you need to learn how to roll someone into the recovery position. Simplified, it means rolling someone towards you onto their side and then making sure their airway is open and they are in a comfortable position.

Helpful hint - When waiting  a long time for the ambulance, roll the casualty onto their other side roughly every 30 minutes which will help balance circulation

Emergency Services


The unresponsive casualty is breathing, you have checked for injuries / illness and when safe to do so rolled them into the recovery position. The next step would be to contact 999 / 112 stating your location and then provide all of the above information to them. They will provide guidance / support and despatch an ambulance / paramedic team to the scene.