Assessment of casualties: Severe bleeding and unresponsive casualties

Control Measure Knowledge

This control measure should be read in conjunction with Share information with other agencies: People at risk


Providing care should not put zero responders in increased danger. They should be advised to remain alert to current hazards and monitor for changes.

Fire control personnel should advise zero responders to give first aid only:

  • If they are not injured themselves
  • If the casualty cannot help themselves
  • To one casualty at a time

Assessment of casualties

Fire control personnel should ask basic assessment questions to help identify casualties most in need of initial lifesaving intervention, such as those who are losing a lot of blood or are not breathing.

Questions based on the Ten Second Triage tool are likely to help fire control personnel to support zero responders to identify these casualties quickly:

Ten Second Triage

  1. Is the casualty able to walk?
    • Yes – Casualties with minor injuries, who are in shock or confused should be told to move to a safe place
    • No – Ask next question
  2. Are there signs of severe bleeding?
  3. Is the casualty talking?
    • Yes – Do they have a penetrating injury to the front or back of their torso, such as a stab wound?
    • Yes – provide initial advice to control severe bleeding. More information can be found in Control measure – Initial advice to save lives: Control severe bleeding
    • No – The casualty should be moved onto their side with their head tilted back to open their airway (recovery position)
    • No – Ask next question
  4. Is the casualty breathing?

Figure: National Ambulance Resilience Unit (NARU) Ten Second Triage tool

If a casualty is unresponsive and losing a lot of blood, fire control personnel should advise callers to start cardiopulmonary resuscitation (CPR) immediately. If the casualty continues to bleed severely, fire control personnel should advise callers to ask someone else, if possible, to apply firm direct pressure to the point of bleeding while they continue with CPR.

If a caller on their own is providing first aid, fire control personnel should advise them that the priority should be CPR, if it is safe to do so, until more help arrives. However, if severe bleeding persists, they should quickly recheck for signs of breathing as continuing CPR may not be necessary (because normal circulation may have returned).

Strategic Actions

Tactical Actions