Emergencies can happen anytime, anywhere, and knowing how to respond can make a critical difference in saving a life. Basic life saving skills equip us with the knowledge to assess a situation, take the right steps, and provide immediate assistance until professional help arrives. This guide covers essential techniques such as CPR, dealing with airway obstructions, treating burns, and more. The key to effective basic life saving is staying calm—easier said than done—assessing the person’s condition, and acting quickly.
“Basic life saving skills” sounds overwhelming and this is a long article, but remember this: “early CPR performed by laypersons can double the chances of survival” (Source 1). You can make a difference, you can save a life. It is always better to have tried something than to have not known what to do.
Sarah Barbezat
Emergency Medical Technician
This article was written after I attended Sarah’s first aid course. She has reviewed the article.
Sarah teaches group classes at your home in the Geneva/Nyon area. I cannot recommend her enough. You can find her here.
Assessing an Emergency Situation
When an emergency occurs, quickly assess the environment and avoid putting yourself in danger or creating another emergency. If a loved one needs help, your instinct may be to act immediately, there will be adrenaline pumping through your body and your mind may be racing. But as much as possible, stay calm and ask yourself two questions to determine the appropriate basic life saving response:
Consciousness: Is the person conscious or unconscious? Sounds simple, but for infants sleep vs. unconsciousness can be hard to differentiate. Consciousness means that the brain is “online.”
Breath: Is the person breathing? Breathing is a sign that the heart is beating; if this is the case then oxygen and blood are circulating through the body. If there is no breath then we need to do a physical maneuver (CPR) to move oxygen and blood throughout the body until help arrives.
Understanding these signs is fundamental to basic life saving skills and ensures you take the right steps in critical moments. Now, we will go into what to do in each scenario. Here is the recap: unconscious and breathing (recovery position); unconscious and not breathing (CPR, ideally with rescue breaths or only chest compressions if airway is obstructed); conscious and not breathing (Heimlich or Back Blows).
Foundations for Basic Life Saving: Understanding Unconsciousness & CPR
A person is considered unconscious when their brain is “offline,” meaning they have no control over their body movements. Their muscles are completely relaxed, unlike when they are asleep, where some muscle tension is maintained, such as bladder control and tongue control. To determine if someone is unconscious, verbally stimulate them by making noise and checking for a response. If it is a baby you can pinch their arm or clavicle and look for a physical response.
If a person is unconscious, the next step is to check whether they are breathing normally. Breathing is the most reliable indicator that the heart is still beating. And inversely, lack of breathing indicates the need for immediate basic life saving intervention—Cardiopulmonary Resuscitation (CPR).
It’s logical, if the heart is not beating then your basic life saving job is to perform a manual intervention, CPR, so that oxygen and blood continue to circulate. Our organs need oxygen to survive. Lack of oxygen causes damage to our brain and heart in as little as 4 minutes and can be fatal.
How to Check for Breathing
Do not bother checking for a pulse, go straight for if they are breathing or not. If they are breathing the heart is beating. In a stressful situation it may be hard to hear breathing, try to rely on your other senses like sight and touch. Take off any clothing on the chest and watch for the chest rising and falling. It should be visible.
Look, feel and listen for breath sounds for 10 seconds. This is a LONG time. Normal breathing in adults ranges from 8–12 breaths per minute, while babies and children breathe faster at about 20–60 breaths per minute. Babies breathing is very irregular up to 3 or 4 months and they can not breathe for up to 20 seconds- an incredibly long time.
You are checking whether the person is breathing and if it is regular. If the person is gasping or breathing very slow this can indicate respiratory or cardiac arrest.
When a person is not breathing, oxygen is not circulating through their body. Their skin will turn a bit blue or purple from this lack of oxygen and may look marbled. If breathing is irregular or slow or absent, you need to put your basic life saving skills into action immediately.
If they are breathing normally but unconscious
The person should be placed in the recovery position to prevent choking. The recovery position is laying on the side so that they don’t choke on their tongue or any regurgitation or vomit. When laying on the side, the airway is open.
- For a baby, you will keep them in your arms in the lateral position. One hand supporting their jaw to keep their head away from their chest and the airway open.
- For a child above the age of 2ish or an adult you can place their top knee over the bottom one so that they are a bit stabilized. Keep the head aligned with the body.
If breathing is irregular or absent
You need to take action immediately. If they are not breathing, it means their heart has stopped, and CPR must begin to keep their organs oxygenated.
Performing CPR
If the person is unconscious and not breathing, it indicates cardiac arrest. You need to start CPR right away. Cardiac arrest is often caused by respiratory arrest in children making rescue breaths absolutely critical. In adults, cardiac arrest is more often cause by other illness or a cardiovascular problem.
Move to a hard surface
If the person is not already laying on the ground, move them to the ground safely.
Rescue Breaths
There is 21% oxygen in the air we breathe in and 19% oxygen in the air we breathe out. So by exhaling our air into someone who is not breathing we are giving them nearly as much oxygen as they would have if they were breathing on their own.
Children have low oxygen reserves, so rescue breaths are critical. Try to have the head aligned with the body so that the airway is open. You don’t need to tilt their head back per se, but aim for a neutral spine. You can normally cover the baby’s mouth and nose with yours, if not you will need to squeeze the nose shut and breathe into the mouth only. Try to watch that the chest rises when you breathe in by tilting your head to look in that direction. Start with 5 initial rescue breaths and then move to chest compressions. After you initiate chest compressions, for children you will alternate with 2 breaths for every 15 compressions.
Teens and adults have more oxygen reserves in their body, and studies have shown that “hands-only CPR” meaning chest compressions alone are just as effective (Source 1) as alternating with rescue breathing, so you can immediately begin chest compressions.
Chest Compressions
You want to press on the sternum- this is where all the ribs come together in the upper part of the chest, in line with the nipples. It is hard. You are going to press very hard, compressing ⅓ of the diameter of the person from their front to back. You cannot press too hard. When a person is unconscious the body is relaxed and it is unlikely to break a rib, but you may hear a crack and this is good. It means you are pushing hard. The backside of where you are pressing is the spinal cord and in between is the heart. Remember you are pushing hard enough to get the heart to pump its blood out and deliver oxygen to the body.
For babies: Use two fingers or two thumbs, pressing to a depth of 3–4 cm.
For children over 2 years old and adults: Use two palms interlocked, arms straight, pressing to a depth of 6 cm.
For everyone, press hard and fast. Maintain a rate of 100–120 compressions per minute. Wannabe by the Spice Girls and Stayin’ Alive by the Bee Gees follow this rhythm.
Chest compressions are performed with interlocked hands and straight arms. They are hard (compressing 1/3 of the diameter of a person) and fast (100-120 beats per minute).
Continue
You will continue CPR until help arrives or the person begins breathing on their own. For children you will do 15 compressions and 2 rescue breaths. For teens and adults you will do continuous chest compressions. Fast and hard for both.
Defibrillator Use: If there is a defibrillator available, you should use it, from 1 year old onward. For infants, place one pad on the front and one on the back. For adults one will be high up on the chest and one lower on the belly. The defibrillator will guide you in the setup and also give you a tempo for the chest compressions. You will still perform CPR if you have a defibrillator, but every 2 minutes or so it will tell you to move away from the person so it can analyze the heart rhythm and give a shock if needed. Then you will resume CPR as above.
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Dealing with Airway Obstructions
The esophagus and the airway run alongside each other in the throat, which means food and small objects can accidentally enter the airway instead of the digestive tract. Airway obstruction is a common fear for parents, especially when introducing solid foods. However, it is important for babies to learn how to chew and swallow properly, which means they should not rely solely on purees. Teaching infants to handle different textures can help reduce the risk of choking over time, and with basic life saving knowledge you will be more confident to properly respond if needed.
Choking occurs when the airway is blocked, and it can be partial or complete. Choking is a critical situation requiring immediate basic life saving interventions.
**This is the only situation where if you are alone, you will intervene with a basic life saving intervention immediately and then call for help. When a person is choking there is only a minute or so before they will lose consciousness. Time is critically important to try to dislodge the object blocking the airway.
Partial Obstruction: If the person can cough or make sounds, encourage them to keep coughing to clear the obstruction naturally themselves. This can be very scary and you want to intervene, but they have a good chance of clearing it themselves through coughing as this causes vibrations in the airways.
Complete Obstruction: If there is no sound, no cough, no crying, then the airway is completely blocked and immediate intervention is required. Their lips and mouth will begin to turn blue, the mouth will be open and the hands will likely be around the neck.
- For babies: Hold them head down over your knee and give 5 firm back blows in between their shoulder blades (see picture below), then turn them over and give 5 chest compressions (as explained above). You will repeat this until the object is expelled or they become unconscious.
- For toddlers and older children: Basically once they can stand you will perform the Heimlich manoeuvre instead of the chest compressions. But you will alternate with the back blows, so begin with 5 firm back blows and then perform 5 abdominal thrusts (the Heimlich manoeuvre) by making a fist and pushing on the belly where it is soft, just under the ribs, inward and upward. Continue to alternate 5 back blows, 5 abdominal thrusts until the object comes out or the person becomes unconscious.
If the person becomes unconscious, you will begin chest compressions immediately and call emergency services. You will not give rescue breaths for children as you would for CPR because the airway is obstructed, therefore the oxygen that you would be breathing into their mouth will not reach their lungs. Continue chest compressions until help arrives.
Other situations where your basic life saving skills can be useful
Managing Bleeding
Heavy or fast bleeding requires immediate action. Apply direct pressure with a clean cloth to slow blood loss. In cases of severe bleeding, create a compression bandage by using a wad of gauze and wrapping tightly. Seek medical help immediately.
Head Trauma
Head injuries should always be monitored, especially in children. For infants under three months, any head injury requires medical evaluation. For older children and adults, watch for warning signs over 24–48 hours, including vomiting, drowsiness, or unusual behavior (more details here). Applying ice can help reduce swelling.
Shaken Baby Syndrome
A baby should never be shaken. Their skull is not yet hard and their brain is floating inside, shaking them can make their brain hit against the skull and cause serious and lifelong damage. Shaking a baby is taking them by their shoulders and repeatedly having their head move forward and backward. It is not bouncing with a baby’s head supported in your hands. Shaken baby causes 20% of death, 65% of irreversible damage and occurs 60% of the time in babies who are under 6 months old.
If your baby is crying a lot and you are overwhelmed, put them down and walk away. Put them in their bed, put them in the middle of the carpet. Put them in a safe environment and regain your composure.
If your baby has been shaken you will likely see the consequences later, like vomiting and irritability.
Sudden Infant Death Syndrome (SIDS)
SIDS is when a baby stops breathing when they are asleep. It is a risk up to one year old, and while the exact cause remains unknown, preventive measures have been widely put in place since 1992 and the incidence of SIDS has greatly reduced.
- Put babies to sleep on their backs. If they roll over themselves this is fine.
- Keep the sleeping environment free of pillows, blankets, and toys. Do not put your baby to sleep with a hat on.
- Avoid overheating and maintain a cool room temperature of 18–20°C. In summer or warmer climates, do not hesitate to have your baby sleep in a diaper only. They will not sleep if they are uncomfortable so let them be your guide.
- Keeping babies away from secondhand and thirdhand smoke (on the clothes and skin of smokers).
For more on SIDS you can read more here.
Fever and Seizures
Fever is common in children and is usually not dangerous. However, in infants under three months, any fever should be checked by a doctor. The state of the child- their behavior, eating and sleeping habits, is more important than the actual temperature of the fever. You want your child to stay hydrated and get undressed so they are not too hot. You can give paracetamol (no ibuprofen until 6 months of age). If you live in Switzerland you can always call the Medecin de Garde, 0848 133 133, for advice.
Febrile seizures occur in 5% of children between six months and six years. It is when they have a fever and then they have a seizure. It often appears as loss of consciousness, eyes roll back, and jerking movements begin. If this happens, let the seizure pass, then place the child in the recovery position and call emergency services. Febrile seizures are not linked to epilepsy.
Burns
Burns require immediate cooling with running cold water for 15 minutes. Do not put ice on burns, do not put any other ”remedies” on burns. Any burn, no matter how minor it seems, should be seen by a pediatrician. Different burn levels require different treatments:
- First-degree (red skin, like sunburn): Cool with running water and apply a clean compress.
- Second-degree (blisters): Cool with running water and seek medical advice. Do not pop blisters.
- Third-degree (charred skin, when the nerve has been burnt, potentially painless): Cool with running water, and cover with a cool, sterile dressing and seek emergency medical help.
Drowning
In Switzerland, drowning is a second leading cause of death in children. In other countries, such as the United States and the United Kingdom, drowning is also a major cause of cardiac arrest in children. While exact rankings may vary depending on the source and methodology, pediatric cardiac arrests are most often caused by respiratory issues, with drowning being one of the most significant.
A child under the age of 3 cannot lift their head up if they slip under water. Floats do not prevent drowning and often provide a false sense of security. Drowning happens in silence and children should always be supervised when in water, even a little baby pool or the bath. If a child is unconscious and not breathing, start CPR immediately.
“Secondary drowning” or “Noyade Seche” is when a child has drunk a bunch of water. Even if a child appears fine after inhaling water, monitor them for eight hours for signs of breathing difficulty or unusual fatigue.
The importance of acting in an emergency
When it comes to basic life-saving skills, the most important rule is to take action. Even if you are unsure or nervous, doing something is always better than doing nothing. Whether it’s performing CPR, helping a choking child, or stopping heavy bleeding, your response can mean the difference between life and death. Stay informed, practice regularly, and be prepared to act in an emergency.
Sources
Abbreviations
CPR, Cardiopulmonary Resuscitation; SIDS, Sudden Infant Death Syndrome
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