Fire control personnel should provide advice to zero responders about casualties who are unresponsive, only in situations when the call cannot be redirected to ambulance control.
The advice that fire control personnel give to callers about unresponsive casualties is designed to help callers take on a zero responder role. However, zero responders should only provide first aid if doing so does not place themselves or others in danger.
Check for breathing
If the caller tells fire control personnel that a casualty is not responding, fire control personnel should determine whether the caller believes the casualty is breathing. To check for signs of breathing, fire control personnel should tell zero responders to:
- Look at the casualty’s chest; it should be moving up and down as they breathe. Does it look normal?
- Listen for sounds of the casualty breathing in and out
If the casualty is showing signs of breathing, they should be rolled gently onto their side, with the head gently tilted backwards a little and the hand of their uppermost arm under the cheek of their face, nearest to the floor. The upper most leg can be drawn up from the knee to stop them rolling forwards or backwards. This is referred to as the recovery position.
Casualties not breathing or not breathing normally
If there is an automated external defibrillator (AED) in the immediate area that can be reached safely and within a minute, fire control personnel should advise the caller – or, ideally, another person is present or if the device is further away (so chest compressions are not interrupted) – to collect it and use it. The AED contains instructions for its use, which a zero responder can follow. Refer to Situational awareness: Calls from or about people at risk – Severe bleeding and unresponsive casualties for more information about accessing first aid equipment.
If the caller believes that the casualty is not breathing, not breathing normally or if they are unsure, it is likely that the casualty is in cardiac arrest. Fire control personnel should advise the caller how to start chest compressions, providing they are willing to and it is safe for them to do so.
Provided fire control personnel believe it would not place the caller in danger, based on the information known, they should advise zero responders to:
- Lay the casualty flat on their back, on a firm surface such as the floor or ground
- Give chest compressions by:
- Placing one hand on top of the other in the middle of the chest
- Interlock fingers, keep arms straight
- Push down hard and fast 5 to 6cm and then release pressure fully
- Continue compressions twice every second (100 to 120 compressions per minute; fire control personnel may help by counting along with the caller as they give the compressions)
- Fully release down pressure of hands on chest after each compression
- Continue to give firm and regular chest compressions until:
- They are physically unable to continue
- Another zero responder takes over
- Emergency responders take over
- If a defibrillator has arrived, open it or turn it on and listen to the voice instructions that will tell them what to do
Fire control personnel should encourage zero responders to not give up, reassuring them that their actions may be helping to stabilise the casualty’s condition until medical help arrives.
For public resources about performing CPR refer to the Resuscitation Council UK guidelines.