DRSABCD is a definition of safe procedure in medical emergencies. The acronym outlines an essential action plan for first aid situations.
Its meaning focuses on maintaining safety for the injured or ill person, as well as others at the scene, simply by prioritising the order of events.
This is first and foremost. Danger needs to be dealt with before anything else.
There is often a physical threat present at first aid situations that involve injuries or illnesses. The potential danger can be a threat to you, to bystanders, as well as to the person already in need of attention.
This danger can be present in many forms, including live wires, overflowing liquids, gases, moving vehicles, dangerous animals and people, sharp objects, falling objects, and more.
The first step in DRSABCD is to make sure you are not at risk from such a hazard. Then try to ensure that no one else is.
If more victims were to be added, first aid quickly becomes unmanageable.
Seek a response to find out if the person needing attention is conscious or not.
The C.O.W.S. method is an effective way to assess whether the casualty is responsive. It’s easy to remember and involves, talking to, touching the casualty, and using both questions and commands.Can you hear me?
Ask, can you hear me? Are you hurt or sick? Also, ask if you can help the casualty. This has the added advantage of gaining consent, or not, as well as eliciting a response.
Instructing the casualty to open their eyes is the most instinctive action the casualty will take, if they are able to. If their eyes are open, are they able to 'look left', 'look right' etc.
Asking their name is also instinctive. It does not matter if they give the correct name, so long as they respond to your question.
Squeeze the casualty's hand to see if they squeeze you back. A casualty that cannot hear you, may feel your squeeze and respond accordingly.
There’s no need to aggressively shake a casualty to gain a response. Definitely don’t shake a child or infant.
Simply touching the casualty’s hand or shoulder and talking assertively is effective and will awaken a sleeping person.
It’s possible for a casualty to be conscious but not respond. For example, a person having an Absence Seizure will be conscious but will be unable to respond to questions and commands.
A casualty who is unresponsive should be treated as unconscious.
If the casualty responds by speaking or moving and appears conscious, leave them in the position in which you found them (provided there’s no further risk of danger).
This response will help determine your next first aid steps.
Conduct a ‘secondary survey’ — a verbal and visual assessment of their condition.
The verbal assessment would include questions such as:
The visual assessment comprises a head-to-toe examination, looking for bleeding, burns, bites, abnormal swelling, etc. Also, checking for medical alert bracelets and the existence of medication in the casualty’s hand or laying nearby.
Get help if you need it. Monitor and reassess the casualty regularly.
First aid treatment is not a substitute for professional medical care. In a medical emergency, you should waste no time calling for an ambulance or emergency services.
In order to stay focused on the casualty, have someone else in your vicinity make the call for help on your behalf.
It’s important to send for help as early as possible.
Triple Zero — 000 — is the national number for Fire, Ambulance and Police emergency in Australia.
An Emergency Call function can be found on the lock screen of any powered-on mobile phone.
112 can be dialled from any mobile phone in Australia, as well as anywhere else in the world with GSM coverage. This system does not use satellite technology, only GSM technology.
106 is a text-based emergency call service for people with a hearing or speech impairment. This service uses TTY (teletypewriter) and does not accept voice calls or SMS messages.
You, or your bystander, should provide basic information, answering the operator’s questions as best as possible.
The operator will ask:
The casualty’s airway should be checked. This takes priority over any injuries.
Obstructions to the pathway to the lungs will restrict breathing. If possible, check the airway without moving the casualty.
If it appears there are obstructions in the casualty’s mouth, you may need to roll the person onto their side — carefully, with their spine, neck and head aligned. This is known as the Recovery Position.
See our guide to placing a person in the Recovery Position.
Open the casualty’s airway by lifting the chin and tilting their head back. Look into the back of the throat to check obstructions, especially:
Clear any debris using your fingers, donning gloves if available.
Children should be managed as for adults. A gradual full head tilt is recommended:
For infants (under 1 year), maintain neutral head position/jaw support. Do not tilt the head back. Their softer trachea can distort and compromise the airway.
Check that the person is breathing.
Look, listen and feel for no more than 10 seconds to assess whether breathing is ‘normal’.
In the first few minutes following a cardiac arrest, the casualty may be taking infrequent, slow and noisy gasps, gurgles or sighs. This type of breathing is ineffective and should be treated as ‘not breathing’.
When the casualty is deemed as not breathing, you should immediately move to the next step C and send someone to find and fetch an AED.
If the casualty is breathing, place them in the Recovery Position and continue to monitor respirations until paramedics arrive.
Having made sure an ambulance has been called, continue to check the casualty’s condition. Observe and re-assess the casualty for continued breathing every 60 seconds.
While waiting for medical help to arrive, assess for injuries and treat accordingly.
CPR should be performed straight away when a person is unconscious and not breathing.
With the person face-up, laying on their back, place the heel of your hand on the centre of their chest, your other hand across the top of it.
Press down firmly to about a third the depth of their chest — about 5cm, or 4cm in the case of an infant.
The rate for compressions is 2 in just over a minute (100/120 compressions per minute).
Following 30 chest compressions, give 2 rescue breaths if you’re comfortable with mouth-to-mouth. To administer, tilt the person’s head back and lift their chin, pinch their nose and place your mouth over theirs.
Adults receive full breaths, shallow breaths for children, and just 2 puffs for infants.
Breaths are optional. If you’re not comfortable with mouth-to-mouth, stick to compressions.
Continue CPR until the casualty responds or until paramedics arrive to take over.
For a detailed step-by-step guide to administering CPR, see our How to Perform CPR article
A defibrillator or AED (automated external defibrillator) is the next step if the person is still unconscious and not breathing.
This portable, compact, lightweight machine can ‘jump start’ the heart. When appropriate, it will automatically deliver an electrical shock aimed at restoring muscle contractions and returning the heart its normal rhythms.
AED units come with pad electrodes, a battery and adapter, if applicable. Verbal instructions are inbuilt with most modern AEDs, making it straightforward to use the device correctly.
Often an AED will be located close by. They are to be found not just in hospitals, clinics, and ambulances, but also in many public places, including schools, shopping malls, libraries, airports and offices.
At the scene of the emergency, you would probably need to ask a bystander to try to locate and fetch the AED.
Assuming an AED is available, use it straight away, following its accompanying instructions. The diagram below shows where to place the AED electrode pads. If you would like to know more about how an AED works and some common myths associated with AED's, please visit our AED First Aid article.
Continue CPR and defibrillation until signs of life resume or until medical professionals arrive to take over.
If an AED is not locally available, the paramedics will arrive with one. Emergency first-responders are typically equipped with and trained to use, AEDs.
Disclaimer: This article is for informational purposes only. It does not constitute, replace, or qualify as any form of first aid training.