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What are the American Heart Association’s Guidelines and Procedures for Emergency Response Procedures, Including Calling 911?

Emergency medical personnel rush an injured victim on a gurney into an ambulance at night

The American Heart Association in combination with the American Red Cross have set certain standards for emergency first aid care.

If an individual is non-responsive, unconscious, and not exhibiting normal breathing, then the following actions must be taken:

  1. Call 911 immediately;
  2. Summon the automated external defibrillator (AED) to be brought to the victim immediately;
  3. Initiate CPR immediately;
  4. Continue CPR until the paramedics arrive; and
  5. Once the AED arrives, apply the AED.

Knowing these guidelines can help you feel confident and prepared in the event an accident should occur. Read on to learn more about these emergency response standards and procedures.

First Aid

The American Heart Association and the American Red Cross have defined first aid, “as helping behaviors and initial care provided to a person for an acute illness or injury.”

Those who administer first aid intend to:

  • Preserve life,
  • Alleviate suffering,
  • Prevent further illness or injury, and
  • Promote recovery.

Anyone in any situation may initiate first aid, including the care you administer to yourself.

Calling 911 for Help

If you intervene in first aid, it is important for you to know:

  • How and when to use the emergency medical services (EMS) system (i.e. by calling 911). CALL 911 immediately! The 911 dispatcher will give you instructions on how to respond to the person in distress. It is always best to err on the side of caution and dial 911 if you think it might be necessary (even if it ends up not being necessary)
  • How to execute the emergency response plan specific to the injury site, if one exists,
  • How to get in touch with the Poison Control Center (1-800-222-1222 in North America),
  • If warranted, you should call for advanced care right away and not allow for excessive delays due to caring for the ill or injured person, and
  • Certain life-threatening ailments should be prioritized over calling for help, including addressing airway, breathing, and circulation or critically uncontrolled bleeding.

Placing an Ill or Injured Person

In general, it is best not to move someone who is ill or injured and requires emergency medical care, particularly when you suspect they have sustained a pelvic or spine injury.

However, if the area is unsafe for you or the injured person, it may be appropriate to move them to a more secure location.

If an ill or injured person is not responsive but is breathing regularly, it may be best to position them in a lateral side-lying recovery position.

Lengthen one of the injured person’s arms over their head and roll their body over to the side so that their head lays on the prolonged arm. Be sure to bend both legs once the injured person is laying on their side in order to stabilize the body.

If the injured or ill person is not responding and is not breathing regularly, go on with life support procedures (see section - First Aid Oxygen Use).

If you suspect the injured person has sustained one of the following types of injuries, it’s important that you don’t roll them onto their side and instead, leave them in the position in which you found them to avoid potentially injuring them further:

  • Neck
  • Back
  • Hip
  • Pelvic

When in an unsafe area or if the injured person’s position is causing their airway to be blocked, move them over as necessary to open up the airway and get to safety.

Placing a Person Who Has Been Shocked

If it appears the injured person has sustained a shock and is responsive and breathing regularly, you may position or maintain the person in a supine position. A person is in a supine position when they are laying down horizontally with the face and torso facing upward, as opposed to the prone position, in which the person is lying face down.

When an injured person does not appear to have sustained trauma or injury, you may elevate the feet and legs about six to 12 inches from the supine position while you wait for emergency medical personnel to arrive. Some examples of accidents that can occur not involving trauma or injury include:

  • Simple fainting
  • The shock from nontraumatic bleeding
  • Sepsis
  • Dehydration

However, it is important not to elevate the feet and legs of a hurt person if they are in shock and doing so causes them to feel pain.

First Aid Oxygen Use

Providing oxygen to someone in need in an emergency setting is not usually regarded as a typical first aid skill. However, you may be able to access oxygen in some first aid situations and it’s important to keep in mind that training is necessary for its use.

It may be reasonable to administer oxygen to a person if they suffer from one of the following:

  • Decompression sickness
  • Advanced cancer with dyspnea and hypoxemia
  • Spontaneous breathing as a result of carbon monoxide exposure

Common Medical Emergencies

Using a Bronchodilator for Asthma

It is considered reasonable to provide first aid using a bronchodilator device to someone with asthma who has trouble breathing.

Recognizing a Stroke

It is best for stroke victims when bystanders can quickly recognize the signs of a stroke and make time-sensitive interventions.

The following symptoms may indicate a person is having a stroke:

  • Facial weakness (droop)
  • Arm weakness
  • Grip weakness on one side of the body
  • Speech disturbance

If someone experiences these symptoms, it is important to call for emergency services right away. It is reasonable for someone providing first aid to the stroke victim to measure their blood glucose and relay this number to emergency service providers. However, it is important not to delay the call for emergency care in an effort to measure blood glucose levels.

Chest Pain

It can be challenging to determine when chest pain originates as a result of a cardiac issue, such as a heart attack or myocardial infarction, as opposed to another reason.

Some of the most common symptoms associated with a potential heart attack include:

  • Chest discomfort
  • Upper body discomfort, including pain or discomfort in:
    • One or both arms
    • Back
    • Neck
    • Jaw
    • Stomach
  • Shortness of breath
  • Nausea
  • Sweating (including a cold sweat)
  • Lightheadedness

Rather than driving the person to a healthcare facility yourself, it is recommended that you call for emergency medical services immediately if you suspect someone is having a heart attack.

One measure to take while awaiting the arrival of emergency medical services is for the heart attack victim to chew and swallow an aspirin, so long as they do not have a known allergy to the drug or have been suggested by a doctor not to ingest it.


Anaphylaxis can occur as a result of an allergic reaction and has the potential to be life-threatening.

While most allergic reactions do not necessitate the use of epinephrine, some can lead to anaphylaxis.

If anaphylaxis occurs, epinephrine is recommended for treatment. It is suggested for those who are most at risk to carry an epinephrine autoinjector at all times.

Some of the most common symptoms of anaphylaxis include:

  • Respiratory challenges (such as wheezing)
  • Cutaneous manifestations (including hives or lip and eye swelling)
  • Cardiovascular impacts (such as hypotension, cardiovascular collapse, or shock)
  • Gastrointestinal cramping and diarrhea

It is important for first aid providers to understand how to correctly administer the auto-injector of epinephrine if the victim cannot safely do so.

Similarly, 911 should be contacted immediately when someone is suspected of anaphylaxis or a severe allergic reaction.

Learn More

For more information on how to treat specific conditions in an emergency first aid setting, review the recommendations from the American Heart Association and the American Red Cross here.

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