Initial advice to save lives: Unresponsive casualties

Control Measure Knowledge

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


The advice that fire control personnel give to callers about unresponsive casualties is designed to help callers take on a zero responder role to help others. However, zero responders should only provide casualty care if doing so does not place them 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
  • 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 (recovery position).

Casualties not breathing

If there is an automated external defibrillator (AED) in the area that can be reached safely, fire control personnel should advise the caller – or, ideally, another person (so chest compressions are not interrupted) – to use it. The AED contains instructions for its use, which a zero responder can follow. Refer to Control measure – 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, or if they are unsure, it is likely the casualty is in cardiac arrest. Fire control personnel should advise the caller how to start chest compressions, providing they are willing to help and it is safe for them to do so.

Fire control personnel may tell callers that this is easy to do and may keep the person alive until medical help arrives.

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
  • 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 5 to 6cm and then release twice per 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 after each compression
  • Do not stop compressions unless they need a short break
  • Continue giving firm and regular chest compressions until other willing volunteers or emergency responders take over

Fire control personnel should encourage zero responders not to give up, reassuring them that their actions may be helping to stabilise the casualty’s condition until medical help arrives.

Strategic Actions

Tactical Actions