D.R.S.A.B.C.D. is an acronym used to highlight the definition of the safety procedure in a medical emergency. It simplifies an action plan for a first aid situation. D.R.S.A.B.C.D. is mainly focused on keeping the safety of someone who has become sick or injured, but it also helps direct others at the scene by showing what actions are prioritised.
What Does D.R.S.A.B.C.D. Stand For?
D is for Danger:
Danger is first step in the D.R.S.A.B.C.D system. Danger is present at every scene, so it is important to identify the danger and ensure it is dealt with before moving on to the rest of the steps.
It is often physical threats that are dangerous in first aid incidents involving an injury or an illness. The danger can threaten the first aider, bystanders and the person in need of first aid attention. Dangers can include:
- Live wires
- Overflowing liquids or gases (such as waves or the sea tides)
- Moving vehicles
- Animals or people
- Sharp objects
Removing risks and hazards is the first step of D.R.S.A.B.C.D. to ensure that no one is injured or taken ill in the course of the treatment to avoid adding to the situation so that it can remain manageable and dealt with quickly and effectively.
R is for Response:
Response refers to the person being treated, as it shows how awake and aware the casualty is and if they are able to give a response. There is a method called C.O.W.S. that can effectively tell if someone is responsive. The method involves talking to and touching the casualty and giving them a question with a command. The C.O.W.S. method is as follows:
Can you hear me?
- Can you hear me?
- Are you hurt or sick?
- Do you need help?
- Can I help you?
This also helps you gain consent from the person to help them or not to gauge their responsiveness.
Open your eyes.
Asking them to open their eyes is an instructive action that is instinctive for the casualty to do. If their eyes are already open, ask them to look left or look right to test their response.
What is your name?
Asking for their name is also natural for them to respond. They don’t need to give you the right answer to show that they are responsive. It is a good response as long as they respond to the question.
Squeeze my hand.
Ask them to squeeze your hand as you are squeezing theirs; if they squeeze back, it is a good response; even if the casualty cannot hear you, they may squeeze back out of instinct, which is a good response.
There is no need to shake the casualty to get a response out of them, and do not shake a child or infant. Taking their hand and talking in an assertive tone is an effective way to wake a sleeping person. It is also possible for the person to be conscious but be unresponsive. If someone has had a Seizure, they will be conscious but can not answer any questions or follow instructions. Anyone who can not respond should be treated as if they are unconscious.
If they are conscious, then conduct another set of questions to see what kind of treatment they might need. Such as:
- What happened?
- Do you have any pain?
- Are you injured?
- Do you feel sick?
- Do you have any medical conditions?
- Is there any medication E.M.T.’s or paramedics need to be aware of?
Then do a visual assessment by doing a head-to-toe examination looking for:
- Animal bites
- Abnormal swelling on the body
- A medical alert bracelet
If needed, call for help and continue to monitor and reassess the casualty regularly.
S is for Send for help:
First aid is not a replacement for professional care; it is just a safeguard to help the casualty until professional medical help arrives. You should not waste any time calling an ambulance and emergency services. If someone else is there, like another bystander, get them to call for help so you can keep your attention on the casualty and give them aid. Remember to:
- Ask someone to locate and fetch an AED if possible
- Shout for help to alert anyone nearby
- If possible, have a bystander call for an ambulance
- If there is no one else around, then call the ambulance on your phone, on speakerphone as to free your hands to help the casualty
Numbers to call:
- Triple zero (000) is the national number for Fire, Ambulance and Police emergencies in Australia. Most phones have an emergency call function on the lock screen of any powered and turned on mobile phone.
- One one two (112)- this number can be called from any mobile phone in Australia and anywhere else with GSM coverage. This system does not use satellites.
- One zero six (106)- this number is a text-based emergency call service for those with hearing or speech difficulties. This service has TTY (or teletypewriter) and cannot hold voice calls or SMS messages (or voice messages).
You or another bystander should be able to provide basic information to the operator’s questions to the best of your abilities. Questions like:
- What emergency service do you need, Ambulance, Fire or Police?
- Where the location of you and the casualty (you can use phone apps to find the exact location like google maps)
- Your name and your phone number to call you back if that is required
- What the nature of the emergency is, Tell them what you think happened and the condition of the casualty
A is for Airway:
The airways need to be checked. The airways take priority over injuries as an obstruction to the lungs will restrict breathing. Try to check the airways without moving the casualty. If there is an obstruction in their mouth, you need to roll them on their side, with the spine, neck, and head aligned. Open the airways by lifting the chin and tilting their head back.
Look to the back of their throat to check for obstructions like:
- Their tongue that has fallen back into the throat
- Foreign items
- Fluids like saliva, mucus or blood
- Vomit or regurgitation (stomach content that has risen up the throat but has not been heaved out
- Any other mouth placements like pricings, dentures or mouth-guards
Use your fingers to clear their mouth and wear gloves; if possible, you can also use their hand in yours to clear the mouth. When clearing the airways, you should use a gradual full head tilt; this includes:
- Placing your hand on their forehead
- Place your fingertips under the tip of their chin
- Gently tilt their head back and lift the chin open to see the airway
If the tongue blocks the airway, the gradual full head tilt should keep it from restrictive breathing. If you are treating an infant under a year old, do not tilt the head fully back; you need a neutral head position and jaw support to not distort the airway.
B is for breathing:
heck if they are breathing by putting your ear to their mouth and looking down at their body; look for:
- The chest rising and falling
- Listen at the person’s mouth for sounds of breathing
- The feeling of air on your cheek
Do this for about 10 seconds to check for normal breathing patterns. Breathing that is
- Noisy gasps
It should be treated as not breathing. If they are classified as not breathing, then go to step C and send for an AED. If they are breathing, place them on their side and make their head, neck and back align and monitor them until emergency services arrive. And reassess breathing every 60 seconds.
C is for CPR (Cardiopulmonary Resuscitation):
CPR needs to be performed the right way when someone is unconscious and not breathing. When they are lying on their back, place the heel of your hand on the centre of their chest and put your other hand on top of it. Press down firmly until you get about a third deep into their chest (or about 5cm or 4cm on an infant). Do about 100/120 compressions per minute.
After every 30 chest compressions, give them 2 rescue breaths if you’re doing mouth-to-mouth. Tilt the head back, lift their chin, pinch the nose, and place your mouth to theirs. Adults need full breaths, shallow breaths for children and 2 puffs for infants. Continue the CPR component of D.R.S.A.B.C.D until the causality is able to respond or until emergency services arrive.
Suppose you are unsure about CRP or do not feel confident in performing it. In that case, it is best to complete a course or certification to make sure that you can perform CPR correctly. Places like First aid Pro or First Aid Course Experts (FACE) do provide training and courses that teach CPR.
D is for Defibrillation:
An AED or an automated external defibrillator is the last step in the D.R.S.A.B.C.D process if someone has not responded to CPR and is still unconscious and not breathing. AEDs are portable, compact machines that can ‘jump start’ the heart. It will deliver an electrical shock that is aimed at the muscle contractions and return the heart to its normal rhythms. The units have pad electrodes, a battery and an adapter.
An AED can be found in places such as:
- Hospitals, ambulances and clinics
- Shopping centres
- Office buildings
At the scene of the emergency, you should ask a bystander to try to locate and fetch the AED. If one is available, use it the right way, following the instructions. AED use is covered in most First Aid training and CRP courses, so if you want to learn to use one properly in an emergency, check to get a certification.